Supervisor, Quality Improvement

Role Overview

• Supervise, coach, develop, and evaluate a team of Quality Improvement Specialists
• Establish team goals, performance expectations, and productivity standards
• Monitor workload distribution and ensure timely completion of quality audits, reporting, and improvement initiatives including ad hoc requests and shifting of priorities as new tasks arise.
• Provide ongoing training, mentoring, and professional development opportunities
• Support hiring, onboarding, performance management, and succession planning activities
• Foster a culture of accountability, continuous improvement, collaboration, and customer service
• Perform and oversee quality auditing activities, including review and analysis of claims data, identification of trends, development of recommendations, and monitoring of corrective actions
• Review audit findings and reports for accuracy, consistency, and completeness
• Monitor quality performance metrics and identify opportunities for process improvement
• Conduct root cause analyses and facilitate corrective action planning with operational stakeholders
• Support development, implementation, and evaluation of quality improvement initiatives
• Ensure quality activities are aligned with organizational priorities, client expectations, and regulatory requirements
• Complete and oversee monthly, quarterly, and annual quality reporting activities
• Assist in the development, maintenance, and evaluation of the annual Quality Improvement Work Plan
• Monitor QI Work Plan metrics and performance trends, escalating concerns and recommending solutions as appropriate
• Support delegation oversight activities, internal audits, and operational policy reviews
• Collaborate with cross-functional teams to ensure accurate implementation of medical and claims payment policies
• Analyze claims, operational, and quality performance data to identify trends, risks, and opportunities
• Develop and present quality performance reports, audit findings, and recommendations to leadership
• Ensure accuracy and integrity of quality data, reporting methodologies, and audit documentation
• Partner with operational leaders to measure effectiveness of improvement initiatives and validate outcomes

Requirements

• 5+ years of healthcare quality improvement, auditing, claims analysis, or related healthcare operations experience
• 2–3 years of supervisory, team lead, or people leadership experience
• Bachelor's degree in Healthcare Administration, Business, Nursing, Health Information Management, or a related field or equivalent combination of education and relevant experience
• Strong knowledge of healthcare claims processing, medical billing, reimbursement methodologies, and medical coding
• Working knowledge of ICD-10, CPT, and HCPCS coding principles
• Experience conducting quality audits and translating findings into process improvements
• Strong analytical and problem-solving skills with high attention to detail
• Advanced Microsoft Excel skills and proficiency with Microsoft Office applications
• Strong written, verbal, and presentation skills
• Ability to prioritize multiple projects and deadlines in a fast-paced environment
• Demonstrated leadership, coaching, and employee development capabilities
• Ability to build effective working relationships across departments.

Benefits

• Avalon Healthcare Solutions is an Equal Opportunity Employer
• Vet/Disability.
• This position description is subject to change at any time.
• Flexible solutions span routine and genetic testing management, automated adherence, and end-to-end diagnostics support.
• Professional development opportunities.