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The Quality Manager owns quality across the organization, from the quality of calls made by RNs, providers, and PSS Engagers to clinical quality outcomes at the population level. This role requires a Registered Nurse who combines strong clinical judgment with excellent computer skills and hands-on experience developing and analyzing quality data. The Quality Manager builds and leads a team of Quality Reviewers, sets the standards and methods they audit against, and turns their findings into measurable improvement across clinical and service quality. This role reports to the SVP of Clinical Services.
CareTalk Health is a fully remote, nationwide virtual medical practice. We partner with Medicare Advantage plans to deliver Annual Wellness Visits and close care gaps, reaching members wherever they are. We believe virtual care isn't a compromise — it's care delivered the way patients actually want it. Our job is to make that experience simple, reliable, and human.
The Quality Manager owns quality across the organization, from the quality of calls made by RNs, providers, and PSS Engagers to clinical quality outcomes at the population level. This role requires a Registered Nurse who combines strong clinical judgment with excellent computer skills and hands-on experience developing and analyzing quality data. The Quality Manager builds and leads a team of Quality Reviewers, sets the standards and methods they audit against, and turns their findings into measurable improvement across clinical and service quality. This role reports to the SVP of Clinical Services.
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Own quality performance across all clinical tiers and channels, including RN, provider, PSS, and Engager call and documentation quality, and organization-wide clinical quality outcomes.
Define and maintain quality standards, audit criteria, and scorecards used to evaluate calls, clinical interactions, and documentation.
Set the quality strategy and roadmap in partnership with the SVP of Clinical Services, translating organizational goals into a concrete audit and improvement plan.
Monitor clinical quality outcomes (e.g., HEDIS and other quality measures) and ensure quality review activity is aligned to closing gaps and improving results.
Hire, supervise, and develop a team of Quality Reviewers; assign workload, set performance expectations, and manage day-to-day team operations.
Conduct calibration sessions across reviewers to ensure consistent, defensible scoring of calls and documentation.
Coach and mentor Quality Reviewers, and build their skills in chart review, call evaluation, and constructive provider feedback.
Own performance management for the Quality Reviewer team, including regular one-on-ones, feedback, and development plans.
Design and maintain quality dashboards and reporting tools that track call quality, clinical outcomes, and reviewer performance over time.
Build and analyze datasets to identify trends, root causes, and improvement opportunities across providers, RNs, and PSS Engagers.
Apply strong computer and analytical skills (e.g., Excel, reporting tools, QA platforms) to turn raw audit data into actionable insight.
Present quality findings, trends, and recommendations to the SVP of Clinical Services and other executive leadership.
Partner with clinical leadership to design improvement plans and targeted education based on quality findings.
Ensure clinical documentation and interactions meet internal standards, clinical protocols, and regulatory requirements.
Serve as the organization's subject matter expert on quality standards, interpreting guidelines consistently across care teams.
Participate in incident reviews, root cause analyses, and internal or external audits as needed.
Collaborate with operations, compliance, and QA-adjacent teams to align quality metrics, workflows, and reporting.
Active, unrestricted Registered Nurse (RN) license required; multi-state license compact.
3+ years of clinical experience, including telehealth, ambulatory, or chronic care management preferred.
Prior experience in quality management, quality assurance, or clinical audit within a healthcare setting; supervisory or team-lead experience strongly preferred.
Excellent computer skills, including demonstrated experience building and analyzing data (e.g., dashboards, spreadsheets, quality scorecards, BI tools).
Comfortable using EMRs, CRM platforms, call recording tools, and QA dashboards.
Strong interpersonal skills and the ability to deliver direct, constructive feedback to providers, RNs, and clinical staff.
Sound clinical judgment paired with a rigorous, data-driven approach to quality.
Effective people leader who develops reviewers and holds a consistent quality bar.
Focused on continuous improvement in both service quality and clinical outcomes.
This is a remote position and may be “on camera” at any time. The Trainer will work from a home office, requiring reliable internet connectivity and a secure, private workspace.
Fully remote role with high visibility and impact
Opportunity to shape learning and development in a growing healthcare organization
Collaborative, cross-functional team environment
CareTalk Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
California applicants: Please review our California Applicant Privacy Notice at Collection before applying. The notice explains the categories of personal information we collect, how we use and retain it, whether we sell or share it, and your privacy rights under California law: https://caretalkhealth.com/california-privacy-notice .
CareTalk Health is a nationwide virtual medical practice serving patients and healthcare organizations through Medicare-billable care.
Visit company websiteJobs and hiring trendsUSD 83000-93000 yearly / year
Full-time
Mid · 3+ years experience
Remote
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