Company:
AHIPL Agilon Health India Private Limited
Job Posting Location:
India_Bangalore
Job Title:
Assistant Manager, Quality Operations
Job Description:
Essential Job Functions:
- Team Leadership and Performance Management 20%
Lead, coach, and develop a team of HEDIS Abstractors and Quality Operations staff. Provide daily oversight, mentoring, and quality assurance to ensure abstraction accuracy, data consistency, and adherence to performance standards. Foster a culture of accountability, continuous improvement, and professional growth.
- Operational Oversight and Data Quality Management 20%
Direct the execution and optimization of HEDIS and supplemental data workflows, including ingestion, validation, and reconciliation. Ensure data accuracy, completeness, and timeliness to meet payer, regulatory, and internal reporting requirements.
- Cross-Functional and External Collaboration 20%
Serve as a key liaison with payers, analytics, IT, and regional quality teams to address data discrepancies, drive operational alignment, and strengthen cross-functional coordination. Represent Quality Operations in payer discussions and collaborative meetings to enhance reporting outcomes and compliance.
- Strategic Process Improvement and Audit Readiness 20%
Identify operational inefficiencies, lead process improvement initiatives, and oversee audit readiness activities, including primary source validation and payer data verification. Develop and maintain process documentation, productivity metrics, and dashboards to track progress toward quality and Stars performance goals.
- Leadership in Quality Strategy and Innovation 20%
Partner with senior leadership to shape and execute strategic initiatives that elevate HEDIS and Stars performance across value-based care markets. Drive innovation in quality operations through enhanced workflows, data-driven insights, and best practice implementation.
Other Job Functions:
- Other duties as assigned.
Required Qualifications:
Minimum Experience
- Minimum 3–5 years of experience in healthcare quality, value-based care, or population health operations.
- Experience with HEDIS and Stars programs, including understanding of NCQA guidelines and measure specifications.
- Demonstrated experience supporting payer or provider quality programs and familiarity with value-based contracts.
- Prior leadership or oversight experience (e.g., managing abstractors or analysts) preferred.
- Strong proficiency in Microsoft Excel (advanced formulas, pivot tables, lookups, etc.) and data visualization tools.
- Experience with quality reporting platforms preferred.
- Excellent analytical, problem-solving, and critical thinking skills.
- Ability to manage multiple priorities, meet deadlines, and communicate findings clearly to both technical and non-technical audiences.
Education & Licensure
- Bachelor’s degree in Healthcare Administration, Public Health, Nursing, Business, or related field.
Skills and Abilities:
Ability to be a team player and exercise initiative in responding to provider requests and concerns in a helpful and courteous manner Provider contracting and customer service techniques General understanding of the health care industry, ideally the provider relations field-desired Excellent interpersonal and telephone communication skills are required Exercise attention to detail; ability to provide accurate data entry Ability to work under pressure with minimal supervision, multi-task, complete projects in a timely fashion and meet deadlines a must Excellent analytical, problem solving and organizational skills a must.
Language Skills: Strong communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Computer Skills: Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint)
Essential Physical Functions:
These are requirements normally expected to perform regular job duties. Incumbent must be able to successfully perform all the functions of the job with or without accommodation.
Location:
India_Bangalore
