Senior National Quality Performance Manager

The Senior National Quality Performance Manager role is based in the United States and involves providing strategic and consulting support for enterprise-wide healthcare quality performance initiatives. Key responsibilities include:

• Leading quality data collection strategies, analytics, and reporting across areas such as quality-rate trending and forecasting, provider performance, CAHPS and survey analytics, health equity, social determinants of health, and external vendor engagement.
• Partnering with health plan quality leaders and enterprise stakeholders to develop and execute quality performance improvement initiatives aligned with strategic objectives.
• Managing complex quality programs and assignments, ensuring deliverables are completed on time, within scope, and within available resources.
• Overseeing quality data ingestion strategies and activities, improving the completeness and accuracy of EHR, HIE, and supplemental data used to support quality performance.
• Independently investigating complex quality issues, using data analysis, project management, and cross-functional collaboration to identify root causes and implement effective solutions.
• Led program execution and changes, maintaining alignment with objectives, and providing leadership and stakeholders with clear updates on progress, risks, issues, and outcomes.
• Analyzing quality performance data to draw actionable conclusions, identify care gaps, and recommend initiatives that improve clinical and operational outcomes.
• Ensuring quality programs meet applicable regulatory requirements and audit guidelines, maintaining roadmaps, deliverables, and timelines that support HEDIS audit readiness and success.
• Collaborating across teams to ensure data moves accurately through required transformations and produces reliable insights for quality improvement.
• Developing, reviewing, and maintaining quality program documentation, including plans, reports, records, and supporting materials.
• Monitoring program risks and escalating unresolved or high-impact concerns appropriately while maintaining strong stakeholder relationships and customer trust.
• Serving as an advanced subject matter resource for the quality team and providing informal guidance, knowledge sharing, and support to colleagues on assigned initiatives and processes.

Requirements include:

• At least 4 years of program or project management experience within healthcare quality, including experience supporting HEDIS targeting, reporting, or comparable quality performance activities.
• Relevant healthcare industry experience and a strong functional understanding of quality programs and performance improvement.
• Experience running queries using Microsoft Azure and/or SQL Server, with the ability to work confidently with healthcare data.
• Strong capabilities in data analysis, manipulation, interpretation, and reporting.
• Excellent quantitative, critical-thinking, analytical, and problem-solving skills, with the ability to simplify complex concepts and communicate them clearly.
• Exceptional attention to detail, organization, and the ability to manage multiple projects and competing priorities.
• Strong verbal, written, presentation, and stakeholder-management skills.
• Proven ability to collaborate effectively across highly matrixed organizations and with diverse functional teams.
• Proficiency with Microsoft Office, particularly Excel, along with the ability to quickly learn and navigate new software platforms.
• Intermediate knowledge of NCQA, HEDIS, CMS, and state-specific regulatory submission requirements is preferred.
• Experience with Microsoft Azure Databricks and SQL is preferred.
• Familiarity with healthcare claims and coding elements such as CPT, CPT II, LOINC, SNOMED, HCPCS, NDC, CVX, NPI, and TIN is preferred.
• Experience working within a managed care organization supporting Medicaid, Medicare, and/or Marketplace programs is preferred.
• PMP certification is preferred.
• Six Sigma Green Belt or Black Belt certification, or comparable coursework, is preferred.

Benefits include an annual salary range of $65,791.66–$142,548.59, with full-time employment and a broad healthcare benefits and compensation package. The role offers exposure to HEDIS, regulatory quality programs, healthcare analytics, health equity, and data-driven care improvement, and the opportunity to contribute to enterprise-level healthcare quality and performance improvement initiatives. The environment is collaborative, cross-functional, and committed to equal opportunity employment.