Manager-Quality Improvement; Remote, North Carolina

The Manager of Quality Improvement provides leadership and operational management of Alliance Health’s Quality Improvement (QI) Program, ensuring alignment with organizational goals, regulatory requirements, and accreditation standards. This position is responsible for translating organizational, regulatory, contractual, and quality priorities into structured improvement initiatives that produce measurable improvements in member outcomes, service quality, organizational performance and health equity.

The manager leads the development of quality improvement initiatives through the application of recognized quality improvement methodologies, data driven approaches, and performance improvement frameworks to drive measurable improvements in quality, access, member experience, and health outcomes. The Manager oversees Performance Improvement Projects (PIPs), quality analytics, data validation, performance measurement, reporting, and regulatory submissions, while ensuring compliance with federal and state Medicaid managed care requirements, accreditation standards, and contractual obligations.

This position is full-time remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office (Morrisville, NC) may be required.

• The role serves as a leader in quality improvement, healthcare analytics, regulatory compliance, performance management, utilizing data-driven insights to identify opportunities, monitor outcomes, and support organizational decision-making
• Execute, deliver, and lead quality strategy, annual work plans, quality committees, governance activities, continuous quality improvement culture, and enterprise quality initiatives
• Oversee development, review, implementation, evaluation, and reporting of PIPs, corrective action plans, quality initiatives, state reports, and regulatory deliverables
• Evaluate intervention effectiveness and sustainability
• Analyze quality, utilization, access, operational, and member experience measures. Calculate absolute and relative change, benchmark comparisons, trend analyses, and identify meaningful performance variation
• Advanced knowledge of Medicaid managed care quality programs, State deliverables, PIPs, QAPI, HEDIS, quality improvement analytics and statistical interpretation methodologies including absolute and relative change calculations, PDSA, Root Cause Analysis, PDSA, Driver Diagrams, process mapping, SMART AIM development etc.
• Incorporate assessment and evaluation of disparities, access barriers, social drivers of health, equity opportunities, and support the development of targeted interventions to improve outcomes
• Stakeholder consultation and collaboration, change management concepts.
• Collaborate with Medical Management, Care Management, Provider Network, Population Health, Analytics, Compliance, Operations, and Executive Leadership to advance quality initiatives across the organization
• Maintain compliance, confidentiality, ethical standards, professional credibility, and current knowledge of healthcare quality trends

• Partner with Clinical Quality Analytics, HEDIS Performance Team, Population Health, Information Technology, and other teams to identify and monitor meaningful quality indicators
• Interpret performance trends and translate data into actionable improvement strategies. Identify signals of improvement, remaining gaps, unintended consequences, sustainability risks, and next best tests of change
• Validate that improvement measures appropriately assess whether interventions are producing intended outcomes
• Responsible for the development of reports, dashboards, and executive presentations to support Quality Improvement initiatives with internal and external stakeholders, including the NC DHHS
• Present complex performance information in a clear, actionable format for operational and executive audiences

• Work with Human Resources to attract, maintain, and retain a highly qualified and well-trained workforce
• Directly supervise staff, conduct evaluations, provide coaching, manage productivity, support hiring, onboarding, retention, and workforce development
• Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
• Ensure all staff are treated with respect and dignity
• Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
• Work to resolve…