Healthcare Quality Specialist

6 days ago


Sacramento, California, United States Hill Physicians Medical Group Full time

Overview: At Hill Physicians Medical Group, we are shaping the future of healthcare by actively managing care that prevents disease, supports chronic conditions, and anticipates the needs of our members. Our team is dedicated to providing high-quality patient care while ensuring compliance with regulatory requirements.

Job Summary: We are seeking a skilled Healthcare Quality Specialist to manage Quality Management (QM) and Health Resource Management (HRM) department functions. The successful candidate will oversee delegated activities, including NCQA, state, and federal regulatory requirements, and health plan delegation oversight programs for all regions.

Key Responsibilities:

  • Directs or oversees preparation for all health plan audits and represents Hill Physicians Medical Group at the audits for UM and QM.


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