Manager, Quality & Network Oversight

2 нед. назад

107k–130k USD / yearUSASeniorRemote

quality assessmentperformance improvementcredentialingnetwork oversight

Manage and run 's Quality Assessment and Performance Improvement (QAPI) program ensuring consistent safety and quality of care across partner network.

Обязанности

We're hiring a Manager, Quality & Network Oversight to own something central to our mission: making sure the care our patients receive is consistently safe and high-quality across every partner in our network. Your primary focus will be building and running 's Quality Assessment and Performance Improvement (QAPI) program — the engine that measures care quality across all of our partners, holds each to the same high standard, and closes the loop when that standard isn't met. You'll also own the vetting, credentialing, and oversight processes that keep every partner accountable to 's quality bar.
This is a build role. You won't be maintaining someone else's quality program — you'll be creating 's, and defining how care quality is measured and upheld across every partner we work with. The work is clinical, strategic, and visible to leadership, and it directly shapes how grows.

Требования

Active, unrestricted Registered Nurse (RN) license.
5+ years as an RN, including 2+ years in clinical quality or patient safety — with home infusion, specialty infusion, or specialty pharmacy / managed care exposure along the way.
Direct experience with a QAPI or equivalent quality improvement program — root cause analysis, corrective and preventive action, and turning reported events into lasting change.
Strong clinical judgment and the confidence to define quality standards and to make and defend care-quality and partner fit-to-service determinations.
Excellent written and verbal communication — able to hold external partners to a standard while keeping those relationships productive.

Будет плюсом

Comfort working with data — building or maintaining dashboards, tracking metrics over time, and using trend data to spot safety and quality signals.
Familiarity with home infusion accreditation frameworks (Joint Commission, ACHC, CHAP) and CMS home infusion therapy requirements.
Infusion-specific certification — CRNI (Certified Registered Nurse Infusion) and/or VA-BC (Vascular Access Board Certified).
CPHQ (Certified Professional in Healthcare Quality), or a commitment to obtain it within the first year.
Experience vetting, credentialing, or managing a contracted provider network Oncology infusion experience; ONS/ONCC chemotherapy-immunotherapy training.
You don't need to check every box. If you meet most of these and are excited about building a quality function that raises the standard of care for patients, we'd love to hear from you.
At , we’re building an outlier company with real impact — and that takes focus, energy, and commitment. If that excites you, we’d love to hear from you. is an equal opportunity employer and welcomes applicants from all backgrounds. We’re committed to building a team that reflects a diversity of perspectives, experiences, and identities.

Другое

is one of the fastest-growing benefits solutions and a category-defining pioneer in employer specialty pharmacy. We are reshaping how life-changing therapies are delivered and financed, ensuring patients get the treatment they need while employers finally get a fair deal.
Specialty drugs and infusions represent nearly 10% of all healthcare spend and are the fastest-growing cost category for employers. tackles this challenge with a novel approach: eliminating hidden markups, expanding access to high-quality infusion providers, and bringing clarity and fairness to how therapies are priced and paid for.
We’re proud to partner with numerous Fortune 500 companies and leading TPAs. Each patient we serve creates immediate ROI: lower costs, improved access, and better care. Join us as we redefine what’s possible in specialty care.
Stand up and own 's QAPI program end to end: intake of every clinical and operational event that impacts patient care, root cause analysis, corrective and preventive action, and closure tracking.
Ensure consistent, high-quality care delivery across all partner networks — nursing agencies, specialty pharmacies, infusion centers, and any future care-delivery partners — so patients receive the same standard of care no matter which partner delivers it.
Define the clinical quality standards every partner must meet and measure performance against them, aligned to recognized frameworks (NHIA quality standards, CMS QAPI methodology).
Build and maintain quality and safety dashboards on real infusion data — working with clinical operations and analytics to give real-time visibility into care delivery across the network, turning reported events into trended, actionable data rather than one-off reports.
Monitor data trends related to safety events and reported incidents on an ongoing basis, proactively surfacing emerging signals (e.g., a rising infusion-reaction rate or a partner-level incident cluster) before they become patient-safety problems.
Develop and trend network-wide quality metrics (e.g., adverse event and infusion-reaction rates, missed/delayed dose rates, partner-level incident rates, credential-lapse rates) and deliver monthly quality and safety reporting to leadership.
Identify variation in care quality between partners and drive it toward a consistent standard through targeted corrective action, education, and escalation when standards aren't met.
Build quality as a shared, distributed capability — equipping clinical operations and partners to identify and report risk — within a just-culture framework that treats events as opportunities to improve the system, not to assign blame.
Own a standardized clinical vetting and onboarding process for new partners, including primary- source verification of licensure, accreditation status, insurance, and clinical competency.
Maintain a documented re-verification cadence (at minimum annually or at each accreditation-renewal cycle) so partners continue to meet 's quality standard throughout the relationship — not just at signing.
Support onboarding of new partners by partnering with our manufacturer and network relations team — providing the clinical vetting and quality sign-off that determines whether a partner meets 's standard.
Serve as the clinical quality gate for network expansion — no new partner or site enters the network without clearing a defined clinical quality bar.
Own quarterly business reviews (QBRs) across all network partners — nursing agencies, pharmacies, and infusion-center partners — holding each to consistent quality and performance standards.
Support network development and geographic expansion, always in service of maintaining care quality as the network scales.