Manager - Quality & Regulatory Reporting

The Manager - Quality & Regulatory Reporting oversees the organization's quality reporting and regulatory compliance programs. The role is responsible for ensuring accurate and timely submission of quality data to CMS, state agencies, accreditation organizations, payers, and other third-party entities. The Manager monitors healthcare regulations and policy changes, evaluates their impact on quality reporting requirements, and collaborates with clinical, operational, IT, interoperability, and population health teams to support compliance, performance improvement, and value-based care initiatives.

• Manages regulatory and quality reporting activities and submission deadlines, ensuring timely and accurate reporting.
• Monitors healthcare policy, regulations, and quality reporting requirements, communicating impacts and recommendations to leadership.
• Serves as a subject matter expert on quality measures, public reporting programs, and value-based care initiatives.
• Coordinates data validation, audit readiness, and reporting compliance processes
• Partners with IT and analytics teams to ensure reporting requirements are accurately translated into operational and technical solutions.
• Supports interoperability initiatives that enhance quality measurement, care coordination, and regulatory compliance.
• Collaborates with population health and operational leaders to improve performance on quality and value-based programs.
• Provides education and guidance to leaders, providers, and staff regarding regulatory and reporting requirements.
• Maintains responsibility for department’s operational excellence; ensures department delivers quality services in accordance with applicable policies, procedures, and professional standards.
• Manages team members, which includes orientation, development and evaluation of team members, and monitoring the provision of delivering quality services. Participates in the recruiting, interviewing, and selecting of team members following policies, guidelines and applicable laws. Evaluates team member’s performance relative to job goals and requirements. Provides coaching to staff, recommends education programs, and ensures adherence to internal policies and standards.
• Maintains responsibility for the fiscal management of department and assures proper utilization of organization’s financial resources.
• Effectively communicates departmental, organization, and industry information to staff.

Work Experience

• 5 years' Experience in healthcare quality, regulatory reporting, accreditation, compliance, or performance improvement Required
• 1 year Project management and leadership experience. Required
• 1 year Experience interpreting healthcare regulations and quality reporting requirements. Required
• 1 year Experience with CMS quality reporting programs and value-based reimbursement models. Preferred
• 1 year Leadership experience in a healthcare quality or regulatory environment. Preferred

Education

• Bachelor's Degree Healthcare, Business, Public Health, Nursing, Related field Required