Quality Assurance Manager

Department : Quality Assurance Reports To : Directors of Community Health & Operations Classification : Exempt Work Arrangement : Hybrid – California Based Schedule : Monday – Friday | 8:30 AM – 5:00 PM Compensation : 78k - 82k annually About Pacific Health Group Pacific Health Group (PHG) is committed to improving health outcomes by addressing the medical, behavioral, and social needs of the communities we serve. Through programs such as Enhanced Care Management (ECM), Community Supports (CS), Community Health Worker (CHW) services, Behavioral Health, and other community-based healthcare programs, PHG works collaboratively with health plans, providers, community organizations, and other partners to support whole-person care.Our work is grounded in accountability, collaboration, innovation, integrity, and a commitment to improving access to high-quality services for vulnerable and underserved populations. Position Summary The Quality Assurance (QA) Manager is responsible for the leadership, development, implementation, oversight, and continuous improvement of Pacific Health Group's organization-wide Quality Assurance program. This position provides quality oversight across PHG programs and operational departments, including Enhanced Care Management (ECM), Community Supports (CS), Community Health Worker (CHW) services, Behavioral Health, Revenue Cycle, Outreach, and other organizational functions as assigned. The QA Manager ensures that services, documentation, workflows, and operational practices align with applicable health plan requirements, contractual obligations, regulatory standards, internal policies and procedures, and established PHG quality expectations. The QA Manager leads routine and targeted audits, develops quality metrics and dashboards, identifies trends and systemic risks, oversees corrective action follow-up, strengthens operational workflows, and works collaboratively with department managers to improve quality, accuracy, consistency, and adherence to applicable requirements. This position provides direct leadership and oversight to assigned Quality Assurance personnel and serves as a key quality resource to the Directors of Community Health & Operations and departmental leadership. The QA Manager is expected to operate proactively and independently within the scope of the position. Quality concerns should be identified through established monitoring and auditing processes rather than solely through leadership escalation. Essential Duties and Responsibilities Quality Assurance Program Management Develop, implement, manage, and continuously improve PHG's organization-wide Quality Assurance program. Establish standardized quality expectations, audit methodologies, monitoring processes, scoring criteria, and reporting requirements. Develop annual and ongoing quality monitoring plans based on organizational priorities, payer requirements, identified risks, audit findings, and performance…