• Provide enterprise leadership for internal clinical quality oversight, performance monitoring, and workforce training across a national Medicare Advantage health plan • Build and lead an internal clinical quality audit function focused on evaluating employee performance, clinical decision-making, documentation, and adherence to policies and workflows • Establish audit methodologies, sampling approaches, scoring criteria, and reporting standards to assess quality and consistency of internal clinical work • Conduct routine and targeted audits across clinical and operational roles (e.g., care management, utilization management, clinical reviews) • Identify performance gaps, patterns of non-adherence, and operational risks; perform root cause analyses to distinguish training, process, and system issues • Develop, implement, and oversee corrective action plans (CAPs) tied to audit findings, including retraining, workflow changes, and performance monitoring • Track corrective action effectiveness and ensure sustained improvement through follow-up audits and trend analysis • Own the enterprise clinical quality training strategy aligned to audit findings, regulatory requirements, and operational priorities • Design and implement role-based, competency-driven training programs that translate clinical standards and policies into practical, repeatable execution • Lead development of standardized curricula, onboarding programs, refresher training, job aids, and performance support tools • Ensure training programs are embedded into day-to-day operations and reinforced through leadership coaching and performance management • Partner with Learning & Development to leverage adult learning principles, delivery modalities, and learning management systems • Integrate audit results and training outcomes into a continuous feedback loop to drive performance improvement • Collaborate with Clinical Operations, Compliance, Human Resources, and Analytics teams to align performance monitoring, training, and corrective action efforts • Present audit findings, performance trends, and improvement plans to senior leadership • Define success metrics for audit performance, training effectiveness, and corrective action outcomes • Develop dashboards and reporting to monitor trends, risks, and improvement over time • Lead, mentor, and develop a team of quality auditors, trainers, and clinical subject matter experts