Quality Project Manager

About Us

We are one of the top accountable care organizations (ACO) in the United States. Our company produces and manages proprietary applications, including multiple physician-facing mobile and web apps designed to enhance care coordination for our ACO participants. We are dedicated to driving innovation and excellence in value-based care.

The ACO Quality Project Manager provides strategic leadership and operational oversight for enterprise-wide quality programs, such as the Medicare Shared Savings Program (MSSP), ACO REACH, and Commercial payer programs. This role is accountable for end-to-end quality program performance, including planning, execution, reporting, audit readiness, and continuous improvement. The Project Manager partners closely with executive leadership, provider consultants, analytics, IT, and practice leadership to translate regulatory and payer requirements into actionable strategies that improve patient outcomes, optimize contractual performance, and mitigate compliance risk.

This position owns quality initiatives from design through results, drives cross-functional alignment, manages complex timelines and dependencies, and ensures measurable, sustainable improvement across the ACO.

• Own the quality strategy for assigned ACO payer programs, aligning annual quality goals with organizational priorities and contractual benchmarks.
• Develop and maintain an annual Quality Improvement Strategic Plan, including targeted interventions, timelines, owners, and success metrics.
• Lead targeted quality improvement efforts for high-impact measures (e.g., diabetes, hypertension, cancer screening), ensuring alignment across clinical, operational, and analytics teams.
• Proactively assess program risk, performance gaps, and readiness, escalating issues and recommending corrective action plans to leadership.

• Provide oversight and accountability for all quality reporting activities, ensuring accurate, complete, and timely submissions across payer programs.
• Direct the development, enhancement, and distribution of Gaps in Care reports for assigned ACO payer programs ensuring reports are actionable and aligned with payer rules.
• Prepare and manage clinical quality measure readiness efforts in collaboration with internal analysts and technical teams, ensuring EHR alignment and measure mapping accuracy.
• Manage quality attestations end-to-end ensuring secure intake (fax, Super Doc App, encrypted email, Sidekick), timely follow-up, tracking, and submission.
• Provide executive-level quality performance updates to leadership, including trends, risks, mitigation strategies, and projected outcomes.

• Oversee data validation processes, claims research, and targeted medical record audits to substantiate numerator compliance and exclusions.
• Analyze performance trends and root causes of underperformance, translating insights into prioritized action plans for practices and consultants.
• Ensure compliance with payer-specific requirements, including MSSP CQMs, ACO REACH HEDR adjustments, HEDIS measures, and Health Equity Plan deliverables.

• Lead practice-facing quality initiatives in partnership with Provider Consultants, driving adoption of standardized workflows and best practices.
• Guide practices through complex quality requirements, helping them operationalize care gap closure, documentation standards, and patient outreach strategies.
• Ensure practices receive timely, clear, and consistent performance feedback and targeted improvement recommendations.
• Serve as an escalation point for quality-related barriers impacting provider performance or patient outcomes.

• Design and deliver scalable training programs for providers, practice staff, consultants, and internal teams on quality programs, documentation standards, and payer requirements.
• Serve as the organizational subject matter expert for assigned ACO payer programs, and related frameworks (MIPS, HEDIS, CQMs, STARS, NCQA).
• Ensure providers and staff are trained on effective EHR and template utilization to support accurate data capture and audit readiness.
• Promote a culture of continuous quality improvement and evidence-based care across the ACO.

• Ensure ongoing compliance with CMS regulations, payer contracts, NCQA…