Training and Quality Manager – Healthcare Operations

Training and Quality Manager – Healthcare Operations 

Lead Quality. Elevate Training. Transform Performance.

💻 Work Setup: Remote
🏢 Department: Operations – Contact Center & Claims
📊 Reports To: Director of Claims & Contact Center / VP of Operations

 

Role Overview 

Great operations are built on great training and strong quality standards.

We are looking for a Training and Quality Manager who can design, implement, and lead enterprise-level QA and training programs supporting healthcare operations across Contact Center and Claims Adjudication teams. This role works closely with client QA and training leaders to ensure calibration, alignment, and compliance with contractual quality standards.

Unlike traditional QA leadership roles, this position requires a hands-on operator mindset. The successful candidate must be willing to step directly into the operation when needed — facilitating training sessions, performing QA audits, supporting nesting teams, and even handling claims or calls to understand operational challenges firsthand.

If you believe the best leaders lead from the front, this role will be a great fit.

Key Responsibilities 

• Lead quality assurance and training programs supporting healthcare operations. 

• Develop and maintain standardized onboarding and certification programs for claims and/or contact center teams. 

• Conduct QA audits, side‑by‑side coaching, and training sessions to improve operational performance. 

• Support underperforming teams through targeted training and QA interventions. 

• Establish and maintain QA scorecards and ensure consistent scoring standards. 

• Participate in internal and client-facing calibration sessions to align quality expectations. 

• Analyze QA trends and identify root causes for errors, performance gaps, and training needs. 

• Partner with Operations leaders to implement improvement initiatives. 

• Track and report QA performance, training completion, and certification results. 

• Ensure training and QA processes comply with HIPAA and client-specific requirements. 
  

Qualifications 

• Minimum 5–7 years of experience in healthcare operations, particularly claims adjudication. 

• At least 2–3 years in a QA, training, or quality leadership role. 

• Strong knowledge of healthcare claims processing (Professional and/or Institutional). 

• Experience conducting QA audits and facilitating training or coaching sessions. 

• Ability to analyze quality trends and implement corrective training initiatives. 
• Strong communication skills and ability to collaborate with operations leaders and stakeholders. 

Core Competencies 

• Operational knowledge of healthcare claims 

• Quality assurance methodology 

• Training facilitation and coaching 

• Data-driven decision making 

• Cross-functional collaboration