Senior Manager for Quality Management

Job Description

As a seasoned Process Excellence leader in the US Healthcare provider operations, your role will involve driving enterprise-grade quality transformation using Six Sigma/Lean methodologies, operational analytics, and advanced quality frameworks to improve patient/provider satisfaction and financial outcomes.**Key Responsibilities:**- Define quality governance by establishing QMS, audits, sampling methodologies, and quality scorecards.- Conduct root cause analysis (RCA) and implement corrective and preventive actions (CAPA) for recurring issues.- Develop dashboards and performance frameworks for SLAs/OLAs including accuracy, first-pass resolution (FPR), denial rates, TAT, and CSAT/NPS.- Identify improvement opportunities in collaboration with client leadership and internal operations, and implement controls to mitigate operational risk, audit findings, and compliance breaches.- Evaluate automation opportunities with Technology/RPA teams (RPA, macros, workflow tools, analytics).- Lead and mentor a team of quality analysts, Black Belts/Green Belts, and project managers.**Qualifications Required:**- 1020 years of experience in US Healthcare provider processes with a minimum of 5 years in Process Excellence/Quality leadership.- Proficiency in Patient Access, Eligibility/Authorization, Coding (ICD/CPT), Charge Entry, Billing, AR & Denial Management, Payment Posting, and Clinical Documentation.- Hands-on experience in setting up QMS, audits, sampling plans, and control charts.- Advanced proficiency in Excel/BI tools (Power BI/Tableau), statistical analysis, and dashboarding.- Strong communication skills, stakeholder management, and client-facing governance experience.In addition, exposure to RPA/Automation programs, analytics-led transformation, EHR/EMR systems (Epic, Cerner), payer guidelines, and prior experience in managing large teams across multiple provider processes and geographies will be beneficial for this role.If you possess strategic problem-solving abilities, quantitative analysis skills, client partnership experience, executive communication skills, change management expertise, stakeholder influence, and team coaching capabilities, you are the ideal candidate for this position. As a seasoned Process Excellence leader in the US Healthcare provider operations, your role will involve driving enterprise-grade quality transformation using Six Sigma/Lean methodologies, operational analytics, and advanced quality frameworks to improve patient/provider satisfaction and financial outcomes.**Key Responsibilities:**- Define quality governance by establishing QMS, audits, sampling methodologies, and quality scorecards.- Conduct root cause analysis (RCA) and implement corrective and preventive actions (CAPA) for recurring issues.- Develop dashboards and performance frameworks for SLAs/OLAs including accuracy, first-pass resolution (FPR), denial rates, TAT, and CSAT/NPS.- Identify improvement opportunities in collaboration with client leadership and internal operations, and implement controls to mitigate operational risk, audit findings, and compliance breaches.- Evaluate automation opportunities with Technology/RPA teams (RPA, macros, workflow tools, analytics).- Lead and mentor a team of quality analysts, Black Belts/Green Belts, and project managers.**Qualifications Required:**- 1020 years of experience in US Healthcare provider processes with a minimum of 5 years in Process Excellence/Quality leadership.- Proficiency in Patient Access, Eligibility/Authorization, Coding (ICD/CPT), Charge Entry, Billing, AR & Denial Management, Payment Posting, and Clinical Documentation.- Hands-on experience in setting up QMS, audits, sampling plans, and control charts.- Advanced proficiency in Excel/BI tools (Power BI/Tableau), statistical analysis, and dashboarding.- Strong communication skills, stakeholder management, and client-facing governance experience.In addition, exposure to RPA/Automation programs, analytics-led transformation, EHR/EMR systems (Epic, Cerner), payer guidelines, and prior experience in managing large teams across multiple provider processes and geographies will be beneficial for this role.If you possess strategic problem-solving abilities, quantitative analysis skills, client partnership experience, executive communication skills, change management expertise, stakeholder influence, and team coaching capabilities, you are the ideal candidate for this position.

Keyskills :
Six Sigmaoperational analyticsroot cause analysisdashboardsSLAsOLAsmacrosanalyticsstakeholder managementquantitative analysischange managementteam coachingtalent developmentLean methodologiesquality governancecorrectivepreventive actions