A Clinical Quality Manager ensures that the quality of the work in a clinical environment is consistent and meets government and industry standards as well as customer expectations. Verifies compliance with health and safety regulations. Coordinates all activities related to quality assurance and monitoring and revises existing processes in order to increase efficiency.
Available on a case-by-case basis for exceptional candidates. Job Summary We are seeking an experienced Senior Director•Clinical Quality Governance & Regulatory to provide executive leadership for clinical quality, patient safety, regulatory compliance, and healthcare governance across a large integrated healthcare system. This individual will drive quality improvement initiatives, ensure regulatory excellence, and partner with executive leadership, medical staff, and governing boards to maintain the highest standards of patient care and operational performance. Must-Have Qualifications Proven experience as a Quality Leader within a large healthcare system or hospital environment. Strong Health Plan experience. Clinical background (RN strongly preferred).
Extensive experience in:
Clinical Quality & Quality Improvement Credentialing Peer Review Patient Safety Risk Management Quality Governance Hands-on experience with: CMS 5-Star Ratings HEDIS Metrics NCQA Accreditation & Outcomes Joint Commission Survey Readiness Experience leading regulatory compliance, accreditation, and quality performance initiatives. Strong executive leadership and cross-functional collaboration skills. Key Responsibilities Lead enterprise-wide clinical quality, patient safety, and regulatory compliance programs. Develop and execute strategies to improve quality outcomes, patient safety, and organizational performance. Oversee credentialing, peer review, risk management, infection prevention, and quality governance functions. Ensure continuous readiness for Joint Commission, CMS, NCQA, and other regulatory surveys. Monitor and improve CMS Star Ratings, HEDIS performance, and NCQA quality outcomes. Partner with executive leadership, medical staff, and governing boards to establish quality goals and accountability. Drive quality metrics, data analysis, reporting, and continuous performance improvement initiatives. Lead multidisciplinary teams while fostering a culture of safety, compliance, and excellence. Preferred Qualifications Master's degree in Healthcare Administration, Nursing, Public Health, Business Administration, or a related field. Active RN license preferred. Certification such as CPHQ, CPPS, or CPHRM (or willingness to obtain).
Pay:
$200,000.00•$225,000.00 per year
Benefits:
401(k) Dental insurance Health insurance Paid time off Application Question(s): Do you have 10+ years of leadership experience in Clinical Quality within a large hospital or integrated healthcare system? Do you have hands-on experience with CMS 5-Star Ratings, HEDIS, NCQA accreditation, and Joint Commission survey readiness? Have you led enterprise-wide Clinical Quality, Patient Safety, Credentialing, Peer Review, Risk Management, and Regulatory Compliance programs? Share the best time and the best number for a quick discussion or email your details to to get a quick reply
License/Certification:
RN License (Required) Ability to
Commute:
Atlanta, GA 30332 (Required) Ability to
Relocate:
Atlanta, GA 30332: Relocate before starting work (Required)