[Hiring] Quality Operations Manager @HarmonyCares

Role Description

The Quality Operations Manager is responsible for national quality operations across HarmonyCares’ programs (MA Stars, MSSP MIPS APP, and ACO REACH). The role establishes the standard for how quality work is executed at scale by:

• Operationalizing annual measure and specification updates through enterprise playbooks and provider/care team education.
• Executing centralized EMR chart abstraction to accelerate gap closure.
• Serving as the Tier 2 escalation point for complex denominator and closure documentation issues.
• Driving continuous improvement by identifying recurring breakdowns and implementing workflow and training updates that reduce rework and improve performance.
• Supporting consistent field execution and contributing to achievement of enterprise quality targets, including 4+ Stars performance and comparable goals for MSSP MIPS APP and ACO REACH.

Qualifications

• Bachelor’s degree or equivalent combination of education/experience in quality, population health, healthcare operations, or a related field.
• 4+ years of experience in MA Stars quality operations and measure execution.
• Stays current on Stars, MSSP MIPS APP, and ACO Reach quality program updates and translates changes into playbooks, education, and operational guidance.
• Strong working knowledge of denominator logic, closure mechanics, acceptable evidence standards, and common failure modes.
• Proficient in locating discrete qualifying evidence (labs, screenings, results, reports) and documenting a clear, traceable evidence trail while navigating EMR workflows at speed.
• Strong PowerPoint skills for playbooks, job aids, and training and advanced Excel skills for trackers and QA logs.
• Demonstrated experience developing enterprise playbooks, workflows, job aids used across multiple markets or teams.
• Demonstrated experience supporting clinical and field team education, including new hire onboarding and ongoing continuing education.
• Demonstrated proficiency performing medical record review and chart abstraction to identify qualifying evidence and support quality gap closure. Athena and/or Navina experience is a plus.
• Experience operating in a matrixed environment with competing priorities and time-sensitive deliverables.

Requirements

• Clinical credential (RN/LPN) or equivalent experience in HEDIS/Stars abstraction, coding, or health information management.
• Relevant certifications such as CPHQ, Lean/Six Sigma, or PMP.
• Experience supporting audit readiness activities, including evidence traceability standards and responding to payer or auditor requests.
• Experience with MSSP MIPS APP and ACO REACH quality programs.

Benefits

• Health, Dental, Vision, Disability & Life Insurance, and much more.
• 401K Retirement Plan (with company match).
• Tuition, Professional License and Certification Reimbursement.
• Paid Time Off, Holidays and Volunteer Time.
• Paid Orientation and Training.
• Great Place to Work Certified.
• Established in 11 states.
• Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!