Quality Manager – Telehealth

This is a fully remote position, open to applicants in United States.

📋 Description

• Take ownership of quality performance across RN, provider, PSS, and Engager calls, as well as documentation and overall clinical quality outcomes within the organization.

• Establish and uphold quality standards, audit criteria, and scorecards.

• Collaborate with the SVP of Clinical Services to define the quality strategy and roadmap.

• Track HEDIS and other quality metrics, aligning reviews with gap closure and enhanced results.

• Recruit, supervise, and cultivate Quality Reviewers; manage workload and daily operations.

• Facilitate reviewer calibration sessions.

• Mentor and coach Quality Reviewers in chart reviews, call evaluations, and provider feedback.

• Oversee reviewer one-on-ones, feedback sessions, and development plans.

• Create and maintain quality dashboards and reporting tools.

• Develop and analyze datasets to uncover trends, root causes, and areas for improvement.

• Utilize Excel, reporting tools, and QA platforms to convert audit data into actionable insights.

• Present findings, trends, and recommendations to executive leadership.

• Collaborate with clinical leadership on improvement initiatives and targeted education.

• Ensure documentation and interactions comply with internal standards, clinical protocols, and regulatory requirements.

• Act as a subject matter expert on quality standards.

• Engage in incident reviews, root cause analyses, and internal or external audits.

• Work alongside operations, compliance, and QA-adjacent teams on metrics, workflows, and reporting.

• Report directly to the SVP of Clinical Services.

⛳️ Requirements

• An active, unrestricted Registered Nurse (RN) license is required; must possess a multi-state license compact.

• A minimum of 3 years of clinical experience, preferably in telehealth, ambulatory, or chronic care management.

• Previous experience in quality management, quality assurance, or clinical auditing within a healthcare environment is preferred.

• Supervisory or team leadership experience is highly desirable.

• Exceptional computer skills, with proven experience in building and analyzing data (e.g., dashboards, spreadsheets, quality scorecards, BI tools).

• Proficient with EMRs, CRM platforms, call recording tools, and QA dashboards.

• Strong interpersonal skills with the ability to provide direct, constructive feedback to providers, RNs, and clinical staff.

• Solid clinical judgment and a meticulous, data-driven approach to quality.

• Effective leadership abilities and skills in reviewer development.

• Windows or Apple (macOS) computers only; no Chromebooks, Linux devices, or smartphones allowed.

• Minimum requirements include Windows 10 or macOS 14 Sonoma.

• Intel Core i5 or AMD equivalent (Windows) or Apple Silicon (Macs) is necessary.

• 16 GB RAM is required.

• Wired headphones are mandatory; built-in microphones are not accepted.

• Minimum internet connection speed of 100 Mbps download and 50 Mbps upload is required.

• An Ethernet cable must connect the computer directly to the router.

• Google Chrome with Amazon Workspaces is necessary.

• A webcam is required for video calls.

• Reliable internet connectivity and a secure, private workspace are essential.

• All work must be conducted physically within the United States; international work is prohibited during scheduled work hours.

🏝️ Benefits

• Fully remote position.

• High visibility and significant impact.

• Opportunity to influence learning and development in a progressive healthcare organization.

• Collaborative and cross-functional team environment.