Regional Quality Lead
CINQCARE
Why Join Grace at Home? Grace at Home is a provider-led, community-based health and care partner dedicated to improving the health and well‑being of those who need care the most, with a deep commitment to high‑needs, urban and rural communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in‑home, because we know a deep understanding of our patient’s race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day. Join us in creating a better way to care. Overview The Regional Quality Lead is accountable for owning market‑level quality performance and strategy across HEDIS, Medicare STARs, ACO, and MSSP programs. This role will provide strategic and operational leadership to ensure regulatory compliance, optimal quality outcomes, and sustained value‑based care performance across assigned markets, products, and payers. The Regional Quality Lead drives measurable improvements in patient outcomes and shared savings results through data‑driven decision‑making, cross‑functional collaboration, and disciplined execution while serving as the primary market authority for overall quality strategy, performance oversight, and continuous improvement. Duties & Responsibilities Own Market Quality Strategy & Performance
- Serve as the accountable leader for regional quality outcomes across HEDIS, Medicare STARs, ACO, and MSSP measures.
- Develop and execute comprehensive, market‑specific quality strategies aligned with organizational priorities and payer requirements.
- Establish performance targets and ensure delivery against quality and shared savings objectives.
- Analyze quality performance data to identify care gaps, trends, and risk areas.
- Design and implement corrective action plans to improve measure performance and outcomes.
- Monitor performance regularly and adjust strategies to ensure continuous improvement.
- Partners with clinical leadership, care management, operations, analytics, and provider groups to drive measure compliance.
- Translate regulatory requirements and measure specifications into actionable operational workflows.
- Align quality initiatives with value‑based contracting and financial performance goals.
- Oversee preparation, validation, and submission of quality reporting to CMS, NCQA, payers, and regulatory agencies.
- Ensure adherence to accreditation, contractual, and compliance standards.
- Coordinate chart reviews, medical record retrieval, audit readiness, and validation processes.
- Monitor changes in quality programs and proactively adapt regional strategy.
- Prepare and present performance reports, risk assessments, and strategic recommendations to regional and national leadership.
- Communicate progress, barriers, and mitigation plans with clarity and executive presence.
$115.33k - $163.3k
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