The Manager, Quality Performance & Value-Based Operations serves as the operational lead supporting organizational quality performance across value-based care programs. This role oversees quality performance reporting, payer operational readiness, contractual quality requirements, executive reporting, and cross-functional initiatives designed to improve clinical quality outcomes and maximize value-based reimbursement. Working closely with Quality Leadership, Analytics, Clinical Operations, Risk Adjustment, Care Management, and payer partners, this position ensures quality initiatives remain aligned with strategic priorities and contractual obligations. Primary Responsibilities Quality Performance & Operations • Lead operational coordination for quality initiatives supporting Medicare Advantage, Commercial, and Value-Based Care programs. • Develop and maintain enterprise quality performance dashboards and operational trackers. • Create patient outreach lists and reporting to support quality improvement initiatives and gap closure activities. • Monitor organizational quality performance against payer and contractual targets. • Develop executive-level presentations and leadership reporting for quality performance, operational reviews, and strategic planning. • Maintain Value-Based Care quality performance and incentive tracking across payer contracts. • Serve as the operational liaison between payer partners and Quality Leadership regarding quality performance and reporting. Contract Performance & Payer Operations • Coordinate quality-related deliverables across value-based payer contracts. • Ensure quality teams understand, monitor, and execute contractual quality requirements. • Support Joint Operating Committee (JOC) meetings as the quality performance representative. • Manage quality reporting components associated with payer agreements and incentive programs. • Maintain operational leadership reporting for Quality, Clinical Documentation Services (CDS), and Risk Adjustment. Quality Improvement • Develop and maintain Quality Improvement (QI) performance tracking tools. • Support quality improvement initiatives through reporting, analytics, and operational project management. • Identify performance trends, risks, and opportunities for improvement. • Collaborate with clinical and operational leaders to prioritize interventions that improve quality outcomes. NCQA & PCMH Accreditation • Support NCQA Patient-Centered Medical Home (PCMH) accreditation activities. • Coordinate project timelines, documentation, evidence collection, and accreditation readiness. • Partner with operational and clinical stakeholders to ensure compliance with accreditation standards. Fraud, Waste & Abuse (FWA) • Maintain Fraud, Waste, and Abuse tracking documentation. • Consolidate analytics into executive reporting and performance dashboards. • Present findings to leadership and provide ongoing reporting to Finance leadership. • Monitor operational progress related to FWA initiatives. Clinical Documentation Services (CDS) • Maintain provider performance scorecards and tracking. • Monitor provider documentation performance and operational metrics. • Partner with leadership to identify improvement opportunities. Additional Responsibilities • Create and maintain executive presentations for Quality Leadership. • Coordinate cross-functional projects involving Quality, Analytics, Finance, Risk Adjustment, and Clinical Operations. • Ensure data integrity across quality reporting and operational dashboards. • Support strategic initiatives that improve quality performance and maximize value-based reimbursement. Key Competencies • Value-Based Care Operations • Healthcare Quality Performance • HEDIS & Stars Performance • Population Health • Payer Operations • Executive Reporting • Healthcare Analytics • Contract Performance Management • Operational Strategy • Cross-functional Leadership • Quality Improvement • Project Management • Dashboard Development • Performance Measurement • NCQA & PCMH Accreditation Qualifications: Level of Education/Field of Study • Bachelor's degree in Business, Economics, Healthcare Administration or related field required; Masters degree preferred Years of Experience • 2-3+ years of previous experience in project management background required • 1+ years of Healthcare experience preferred Describe Type of Experience • Proven track record of delivering operational results in a matrixed environment • Background in in healthcare or value-based care • Excellent communication and interpersonal skills with ability to influence stakeholders through clear, professional and confident presentations • Advanced Microsoft office suite skills The compensation for this role includes a base pay range of 99K-149K, with the actual pay determined by factors such as skills, experience, education, certifications, geographic location, and internal equity. Additional compensation may be available through shift differentials, bonuses, and other incentives. Base pay is only a portion of the total rewards package.