Quality Operations Manager

Overview

HarmonyCares is a leading national value-based provider of in-home primary care services for people with complex healthcare needs. Headquartered out of Troy, Michigan, HarmonyCares operates home-based primary care practices in 14 states. HarmonyCares employs more than 200+ primary care providers to deliver patient-centered care under an integrated, team-based, physician-driven model.

Our Mission – To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.

Our Shared Vision – Every patient deserves access to quality healthcare.

Our Values – The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.

Why You Should Want to Work with Us

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!

More details about the benefits we offer can be found at https://careers.harmonycares.com/benefits .

Responsibilities

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, and serving as the Tier 2 escalation point for complex denominator and closure documentation issues. This role drives continuous improvement by identifying recurring breakdowns and implementing workflow and training updates that reduce rework and improve performance. This position supports consistent field execution and contributes to achievement of enterprise quality targets, including 4+ Stars performance and comparable goals for MSSP MIPS APP and ACO REACH.

Essential Duties and Responsibilities

Maintain national quality playbooks and a shared knowledge base and keep guidance current with annual measure and specification updates and field feedback

Drive continuous process improvement by analyzing recurring closure misses and field questions, then implementing workflow changes, job aids, and targeted education to improve closure rates and reduce rework

Deliver provider / care team education, including new provider onboarding and ongoing continuing education, with practical “how to close” training and examples of acceptable evidence

Align stakeholders without formal authority and drive adoption of standard work across regions

Execute centralized EMR chart abstraction to identify qualifying evidence and document a traceable evidence trail to support closure of contracted quality gaps

Manage the Tier 2 escalation queue for complex denominator and closure documentation issues

Provide consistent guidance and closed-loop resolution back to Sr. Population Health Managers

Support audit readiness by reinforcing documentation and evidence traceability standards, completing readiness checks and spot audits, and coordinating auditor-facing requests

In this role you may work with. . .

Senior Population Health Manager

Executive Directors

Clinical and administrative field teams

Qualifications

REQUIRED Knowledge, Skills and Experience

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 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

Preferred Knowledge, Skills and Experience

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

Posted Min Pay Rate

USD $84,000.00/Yr. Posted Max Pay Rate

USD $120,000.00/Yr. Pay Transparency

Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations.

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, and serving as the Tier 2 escalation point for complex denominator and closure documentation issues. This role drives continuous improvement by identifying recurring breakdowns and implementing workflow and training updates that reduce rework and improve performance. This position supports consistent field execution and contributes to achievement of enterprise quality targets, including 4+ Stars performance and comparable goals for MSSP MIPS APP and ACO REACH.

Essential Duties and Responsibilities

Maintain national quality playbooks and a shared knowledge base and keep guidance current with annual measure and specification updates and field feedback

Drive continuous process improvement by analyzing recurring closure misses and field questions, then implementing workflow changes, job aids, and targeted education to improve closure rates and reduce rework

Deliver provider / care team education, including new provider onboarding and ongoing continuing education, with practical “how to close” training and examples of acceptable evidence

Align stakeholders without formal authority and drive adoption of standard work across regions

Execute centralized EMR chart abstraction to identify qualifying evidence and document a traceable evidence trail to support closure of contracted quality gaps

Manage the Tier 2 escalation queue for complex denominator and closure documentation issues

Provide consistent guidance and closed-loop resolution back to Sr. Population Health Managers

Support audit readiness by reinforcing documentation and evidence traceability standards, completing readiness checks and spot audits, and coordinating auditor-facing requests

In this role you may work with. . .

Senior Population Health Manager

Executive Directors

Clinical and administrative field teams

REQUIRED Knowledge, Skills and Experience

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 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

Preferred Knowledge, Skills and Experience

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