Sr. National Quality Contract Manager

Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

The Sr. National Quality Contract Manager is a hands-on, expert leader who works directly with teams to translate high-level quality goals into executable, in-the-weeds solutions. This role is responsible for analyzing data, diagnosing root causes, and implementing specific, repeatable processes that drive meaningful quality outcomes. Serving as a primary point of contact for complex quality challenges, the Senior Manager works in the trenches to enhance performance in models like Stars, HEDIS, and MIPS, ensuring compliance and directly reducing the burden on our providers and care teams.

• Engage directly with Market and Provider teams to analyze and address specific contract quality challenges, designing and executing targeted solutions that drive measurable improvements in quality outcomes.

• Build, refine, and enforce repeatable processes that ensure the organization meets its annual contract quality goals, translating high-level objectives into practical, day-to-day actions for operational teams.

• Drill down into and resolve complex challenges in clinical quality and transitional care domains, directly impacting patient outcomes and contract performance.

• Use data to assess the effectiveness of various contract quality initiatives in the near term and make adjustments as necessary. 

• Translate complex regulatory requirements from models like STARS, HEDIS, and MIPS into clear, actionable workflows for Market Teams and Providers, ensuring they have the tools to achieve compliance and strong performance.

• Work with Analytics and Market leaders to develop and enhance contract quality reporting tools.

• Actively partner with Technology and Analytics teams to spec out, test, and deploy tools and automations that directly reduce administrative burden on care teams, enabling them to focus on patient care.

• Promote and clearly document the use of standardized processes to ensure consistency and efficiency across the organization.

• 3+ years of relevant working experience
• Strong project management and data analytics skills
• Strong presentation and communication skills
• Medical record reviewing/ measure compliance expertise
• Healthcare experience required; Experience with Quality programs such as MSSP, CMS Medicare
• Advantage Star Ratings or HEDIS strongly preferred
• Strong knowledge of Excel
• Must comply with HIPAA rules and regulations

The salary range for this role is $106,000.00 - $118,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 15% and restricted stock units. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

All your information will be kept confidential according to EEO guidelines.

Technical Requirements (for remote workers only, not applicable for onsite/in office work):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.