Quality Operations Manager

The Quality Operations Manager role at HarmonyCares supports national quality operations for in-home primary care services provided to patients with complex healthcare needs. HarmonyCares operates home-based primary care practices in 14 states under an integrated, team-based model. This position manages quality programs including MA Stars, MSSP MIPS APP, and ACO REACH from a United States location.

Responsibilities

• Maintain national quality playbooks and a shared knowledge base, updating guidance with annual measure and specification changes and field feedback
• Analyze recurring closure misses and field questions to implement workflow changes, job aids, and targeted education that improve closure rates and reduce rework
• Deliver provider and care team education, including new provider onboarding and ongoing continuing education with practical closure training and examples of acceptable evidence
• Execute centralized EMR chart abstraction to identify qualifying evidence and document traceable evidence trails for contracted quality gaps
• Manage the Tier 2 escalation queue for complex denominator and closure documentation issues, providing closed-loop resolution to Senior Population Health Managers
• Support audit readiness by reinforcing documentation and evidence traceability standards, completing readiness checks and spot audits, and coordinating auditor-facing requests

Requirements

• Bachelor’s degree or equivalent combination of education and experience in quality, population health, healthcare operations, or a related field
• 4+ years of experience in MA Stars quality operations and measure execution
• Current knowledge of Stars, MSSP MIPS APP, and ACO REACH quality program updates with ability to translate changes into playbooks, education, and operational guidance
• Working knowledge of denominator logic, closure mechanics, acceptable evidence standards, and common failure modes
• Proficiency locating discrete qualifying evidence in EMRs and documenting traceable evidence trails
• Strong PowerPoint skills for playbooks, job aids, and training materials; advanced Excel skills for trackers and QA logs
• Experience developing enterprise playbooks, workflows, and job aids used across multiple markets or teams
• Experience supporting clinical and field team education, including new hire onboarding and ongoing continuing education
• Proficiency performing medical record review and chart abstraction to identify qualifying evidence; Athena and/or Navina experience is a plus
• Experience operating in a matrixed environment with competing priorities and time-sensitive deliverables
• Clinical credential (RN/LPN) or equivalent experience in HEDIS/Stars abstraction, coding, or health information management preferred
• Certifications such as CPHQ, Lean/Six Sigma, or PMP preferred
• Experience supporting audit readiness activities, including evidence traceability standards and responding to payer or auditor requests preferred
• Experience with MSSP MIPS APP and ACO REACH quality programs preferred

Benefits

• Health, Dental, Vision, Disability and Life Insurance
• 401K Retirement Plan with company match
• Tuition, Professional License and Certification Reimbursement
• Paid Time Off, Holidays and Volunteer Time
• Paid Orientation and Training