EXL

We make sense of data to drive your business forward. #MakeSenseofData #DriveYourBusinessForward #PartnerYourWay

Quality Manager, Healthcare

ManagerManagerFull TimeRemoteTeam 10,001+H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

59 days ago

Salary

$100K - $120K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Lead and develop a team of auditors responsible for clinical, coding, and operational quality reviews. • Ensure all audit work meets accuracy, completeness, and timeliness standards. • Track quality performance metrics and KPIs, identifying trends and implementing improvements. • Maintain standardized workflows and audit methodologies across programs and team members. • Identify quality or process gaps within the team and operational area being audited. • Analyze trends, recommend improvements, and implement solutions in partnership with AVP. • Ensure corrective actions and process enhancements are applied to prevent recurring issues. • Collaborate with global quality partners to align processes, metrics, and best practices. • Manage team workload, capacity planning, and productivity to meet program goals. • Provide coaching, training, and feedback to enhance team knowledge and performance. • Ensure auditors maintain strong process and operational knowledge to execute high-quality audits. • Monitor audit consistency and quality through regular calibration and performance reviews. • Oversee the creation of team reports and dashboards to monitor audit outcomes and KPIs. • Ensure actionable insights are derived from audit results to guide process improvements. • Provide comprehensive reports and recommendations to leadership and stakeholders, supporting decision-making.

Job Requirements

  • Minimum 5–7 years of experience in healthcare quality, auditing, or quality operations.
  • Proven experience leading and managing professional teams, preferably in healthcare audits or clinical quality.
  • Clinical (nursing) or coding background preferred; experience in payment integrity, healthcare operations, or third-party liability a plus.
  • Strong analytical and problem-solving skills; able to identify trends and recommend actionable solutions.
  • Ability to manage multiple priorities and projects while maintaining attention to detail.
  • Excellent verbal, written, and presentation communication skills.
  • Digital mindset, comfortable with dashboards, Excel, and audit/reporting tools.
  • Knowledge of process improvement methodologies (Lean, Six Sigma, or equivalent) preferred.
  • Registered Nurse, Associate's or Bachelor's degree.
  • Certification in quality or process improvement preferred (e.g., Lean, Six Sigma a plus).

Benefits

  • EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.
  • From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants.
  • You can expect to learn many aspects of businesses that our clients engage in.
  • You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth.
  • We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.

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