Quality Manager (Remote | Telehealth)

The Quality Manager owns quality across the organization, from the quality of calls made by RNs, providers, and PSS Engagers to clinical quality outcomes at the population level. This role requires a Registered Nurse who combines strong clinical judgment with excellent computer skills and hands-on experience developing and analyzing quality data. The Quality Manager builds and leads a team of Quality Reviewers, sets the standards and methods they audit against, and turns their findings into measurable improvement across clinical and service quality. This role reports to the SVP of Clinical Services. 

Quality Program Oversight 

• Own quality performance across all clinical tiers and channels, including RN, provider, PSS, and Engager call and documentation quality, and organization-wide clinical quality outcomes. 

• Define and maintain quality standards, audit criteria, and scorecards used to evaluate calls, clinical interactions, and documentation. 

• Set the quality strategy and roadmap in partnership with the SVP of Clinical Services, translating organizational goals into a concrete audit and improvement plan. 

• Monitor clinical quality outcomes (e.g., HEDIS and other quality measures) and ensure quality review activity is aligned to closing gaps and improving results. 

Team Leadership 

• Hire, supervise, and develop a team of Quality Reviewers; assign workload, set performance expectations, and manage day-to-day team operations. 

• Conduct calibration sessions across reviewers to ensure consistent, defensible scoring of calls and documentation. 

• Coach and mentor Quality Reviewers, and build their skills in chart review, call evaluation, and constructive provider feedback. 

• Own performance management for the Quality Reviewer team, including regular one-on-ones, feedback, and development plans. 

Data Development & Analysis 

• Design and maintain quality dashboards and reporting tools that track call quality, clinical outcomes, and reviewer performance over time. 

• Build and analyze datasets to identify trends, root causes, and improvement opportunities across providers, RNs, and PSS Engagers. 

• Apply strong computer and analytical skills (e.g., Excel, reporting tools, QA platforms) to turn raw audit data into actionable insight. 

• Present quality findings, trends, and recommendations to the SVP of Clinical Services and other executive leadership. 

Coaching, Compliance & Cross-Functional Work 

• Partner with clinical leadership to design improvement plans and targeted education based on quality findings. 

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

• Serve as the organization's subject matter expert on quality standards, interpreting guidelines consistently across care teams. 

• Participate in incident reviews, root cause analyses, and internal or external audits as needed. 

• Collaborate with operations, compliance, and QA-adjacent teams to align quality metrics, workflows, and reporting. 

• Active, unrestricted Registered Nurse (RN) license required; multi-state license compact. 

• 3+ years of clinical experience, including telehealth, ambulatory, or chronic care management preferred. 

• Prior experience in quality management, quality assurance, or clinical audit within a healthcare setting; supervisory or team-lead experience strongly preferred. 

• Excellent computer skills, including demonstrated experience building and analyzing data (e.g., dashboards, spreadsheets, quality scorecards, BI tools). 

• Comfortable using EMRs, CRM platforms, call recording tools, and QA dashboards. 

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