Sr. Manager, Quality & Delegation

How You’ll Make An Impact At Strive Health, patients come first. We’re on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health journey. Our work reduces emergency visits, improves outcomes, and helps patients live fuller lives. You’ll work alongside passionate Strivers who care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you’re looking for meaningful work where your contributions truly matter, you’ll feel right at home at Strive! Benefits & Perks Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits. Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts. Financial & Retirement Support – Competitive compensation with a performance-based bonus program, 401k with employer match, and financial wellness resources. Time Off & Leave – Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves. Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend. To learn more about our offerings, click here. WHAT YOU'LL DO The Sr. Manager, Quality and Delegation serves as a quality liaison to support care management teams in monitoring NCQA performance through the clinical audit process and ensuring compliance with care delivery and documentation requirements. This individual is responsible for monitoring audit interrater reliability within all Kidney Hero audit tools focusing on NCQA. The Sr. Manager, Quality and Delegation utilizes clinical and quality expertise for the review of documentation and processes against Strive expectations and standards, accreditation and contract requirements, and clinical standards for medical appropriateness. This position reports to the Director, Enterprise Quality. THE DAY TO DAY Oversee Complex Care Management (CCM) audit program to ensure timely monthly completion and alignment with Strive quality standards (including completion of audits). Serve as clinical lead on delegation audits and NCQA CM and PHP accreditation chart readiness (including file preparation, mock audits, gap closure, ongoing monitoring and compliance). Synthesize qualitative audit insights and quality performance data to inform enterprise CCM performance strategy, guiding clinical leadership in advancing care delivery effectiveness, documentation integrity, and alignment with evidence-based standards. Monitor CCM program changes to ensure alignment with NCQA and Strive standards. Provide subject matter expertise and support to clinical managers on the use of Clinical and Quality policies, tools and reports and in the implementation of Quality recommendations for improvement. Oversee routine NCQA and ad-hoc quality audit activities to ensure compliance with Strive, payor, and NCQA standards, drive timely audit execution, and promote consistent audit determinations through interrater reliability reviews and coaching. Partner with Quality Improvement and analytics leadership to design, implement, and continuously enhance clinical audit content, tools, and supporting policies to advance audit program performance. Actively cross-train on NCQA and other clinical contractual requirements of Strive Health,demonstrating flexibility to meet client/consumer needs. Meet in person with internal and/or external stakeholders to facilitate team and business priorities/opportunities. Business travel may be required for opportunities to connect with stakeholders, serve patients, and attend Strive-sponsored team events. MINIMUM QUALIFICATIONS High school diploma or GED equivalent. 9+ years' experience in Quality Improvement, Quality Management, or combined related education, experience, or certification. 2+ years NCQA accreditation experience. Efficient and reliable transportation, including an active driver's license, allowing for travel across an assigned region to meet business needs. Ability to travel and be on-site to meet business needs. Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60ms. PREFERRED QUALIFICATIONS Active, unrestricted RN license. Proficiency in Microsoft Office, Adobe Acrobat and internet/web navigation. Care Management Certification. Knowledge of the organization of medical records, medical terminology, and disease process. ABOUT YOU Strong clinical assessment and critical thinking skills. Ability to work in a team environment. Excellent verbal and written communication skills. Flexibility and strong organizational skills. Annual Base Salary Range: $108,500 - $136,000 Final compensation will be determined based on location, experience, and qualifications. Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talentacquisition@strivehealth.com. We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means.

Oversee the Complex Care Management audit program and serve as the clinical lead for NCQA accreditation and delegation audits. Synthesize quality performance data to guide clinical leadership in improving care delivery effectiveness and documentation integrity.

Requires a high school diploma and at least 9 years of experience in Quality Improvement or Management, including 2+ years of NCQA accreditation experience. A valid driver's license and the ability to travel for business needs are mandatory.

• Medical Insurance • Dental Insurance • Vision Insurance • Employee Assistance Programs • Employer-paid Life Insurance • Voluntary Life Insurance • Disability Insurance • Health Spending Accounts • Flexible Spending Accounts • Performance-based Bonus Program • 401k With Employer Match • Financial Wellness Resources • Paid Holidays • Vacation Time • Sick Time • Paid Birthgiving Leave • Bonding Leave • Sabbatical Leave • Living Donor Leaves • Family Forming Services Through Maven Maternity • Physical Wellness Perks • Mental Health Support • Annual Professional Development Stipend

Relevées dans la description du poste. Confirmez les exigences importantes ci-dessus.

• Quality Improvement
• Quality Management
• NCQA Accreditation
• Clinical Audit
• Care Management
• Interrater Reliability
• Clinical Assessment
• Critical Thinking
• Microsoft Office
• Adobe Acrobat
• Medical Terminology
• Documentation Integrity
• Stakeholder Management
• Compliance Monitoring
• Gap Closure
• Performance Strategy

Formation minimale

Certificat de métier

Expérience minimale

10+ ans