Quality Manager (Nova)
Stellar Health
- Saint Paul, Illinois, United States
- Saint Paul, Illinois, United States
About
Stellar Health is seeking a Quality Manager to lead quality performance strategy and execution across our MSSP ACO, Medicare Advantage, Commercial, and other value‑based contracts. In this role, you will be responsible for managing quality measurement, monitoring, reporting, and submission processes to ensure Stellar consistently meets or exceeds contract performance thresholds. While the majority of your time will be dedicated to Stellar’s value‑based lines of business, up to 25% of your time may focus on serving as a subject‑matter expert and leader supporting Stellar’s broader technology platform business. How you’ll make an impact
Own end‑to‑end quality performance, including measurement, monitoring, reporting, and submission processes to ensure we meet or exceed all contractual quality thresholds. Design and implement strategic initiatives focused on improving outcomes in preventive care and optimizing Stellar processes and workflows. Own relationships with external vendors and partners who support/advise on the quality submission processes. Advise ACO leadership on performance trends, identify opportunities for improvement, and contribute to setting cost and quality contract targets. Establish and track key performance indicators (KPIs) to measure the impact of interventions and guide future strategy. Serve as the subject‑matter expert on CMS and payer quality programs (MSSP, Medicare Stars, MIPS, HEDIS, eCQMs), translating complex requirements into actionable workflows. Manage all supplemental data submission workflows, including chart retrieval, data integrity checks, and validation audits. Lead primary source verification (PSV) audit protocols, partnering with practices to ensure chart‑level compliance with NCQA standards. Work directly with network practices to co‑design workflows that optimize quality performance, providing hands‑on training and education on best practices. Collaborate across internal teams (Product, Analytics, and Operations) to build scalable, consistent data workflows and provider‑facing tools. What you’ll bring
6+ years of experience in healthcare, with a strong focus on Medicare and/or Medicare Advantage. 4+ years of direct experience in healthcare quality, including hands‑on management of end‑to‑end quality submissions for an ACO or health plan. Proven success developing and implementing quality initiatives that measurably improve health outcomes and exceed industry benchmarks. Expert‑level knowledge of HEDIS, MIPS, and MSSP ACO quality reporting requirements. A Bachelor’s degree in Healthcare, Public Health, or a related field. Preferred qualifications
Clinical background (RN, LPN, MA). Experience in a fast‑paced startup environment. Background in Process Improvement methodologies. Perks & benefits
Medical, Dental and Vision Benefits Flexible PTO Universal Paid Family Leave Company‑sponsored One Medical memberships and Citibike memberships Medical Travel Benefits An annual wellness stipend for wellness, pet care, childcare, WFH items, or charitable donations Stock Options & a 401(k) matching program Career development opportunities like Manager Training, coaching, and an internal mobility program A broad calendar of company‑sponsored social events for both in‑office and remote employees Diversity is the key to our success
Stellar Health is an equal‑opportunity employer and we are open to all qualified applicants regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or expression, veteran status, or any other legally protected status.
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Languages
- English
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