Manager, Quality Performance

Company Overview:

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurse practitioners, LCSW’s, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health!

Job Title & Role Description:

The Manager, Quality Performance is accountable for enterprise performance across all quality measures, including HEDIS, Star Ratings, and client-specific metrics. This role owns the prioritization, execution strategy, and cross-functional alignment required to achieve quality targets across all markets. The Manager ensures that quality initiatives are translated into consistent, high-impact execution, driving measurable improvements in clinical outcomes and value-based performance.

Primary Responsibilities:

Enterprise Quality Performance Ownership

• Accountable for leading efforts to achieve metric targets across all quality measures, including numerator capture, gap closure, and Star Ratings
• Own prioritization of quality initiatives across measures, markets, and teams based on impact and organizational goals
• Make trade-off decisions on resource allocation, workflow focus, and intervention strategies
• Monitor enterprise metric performance trends and take action to address gaps and risks

Execution Strategy & Operational Leadership

• Translate quality insights and organizational goals into scalable execution strategies across care teams
• Define workflows, metric expectations (including annual measure targets), and operating cadence to drive consistent results
• Monitor CMS, state health departments, and NCQA to stay ahead of market trends and client expectations, in close collaboration with health plan partners
• Ensure standardized execution of quality workflows across markets and roles
• Identify and resolve operational barriers impacting metric performance

Team Leadership & Accountability

• Build and lead the quality performance function, including Quality Coordinators and Quality Specialists
• Set clear expectations for productivity, accuracy, and performance metric outcomes
• Establish accountability structures, including daily/weekly performance metric management and coaching
• Drive a high-performance culture focused on execution, ownership, and continuous improvement

Cross-Functional Alignment & Influence

• Drive accountability across Clinical Operations, Provider Network, Quality, and Client Services to achieve performance targets
• Align stakeholders on priorities, workflows, and metric performance expectations
• Escalate and resolve cross-functional barriers to quality performance
• Partner with leadership to ensure alignment between quality strategy and operational execution

Performance Reporting & Decision Support

• Own metric performance visibility across enterprise, market, and team levels through dashboards and reporting
• Translate data into clear insights and action plans that drive performance improvement
• Present performance metric results, risks, and recommendations to leadership
• Ensure effective use of data and tools to support execution and accountability

Required Qualifications:

• 5+ years of experience in healthcare quality, population health, or value-based care
• Strong understanding of HEDIS, Star Ratings, and gap closure metric drivers
• Experience managing teams and driving measurable metric outcomes
• Experience with EHR and supplemental data tools (e.g., Navina, Arcadia)

Competencies:

Enterprise Performance Ownership

Drives accountability for quality outcomes across the organization, ensuring alignment between strategy, execution, and results.

Operational Leadership

Leads execution at scale by establishing structured workflows, clear expectations, and consistent operating rhythms.

Data-Driven Decision Making

Uses data to prioritize initiatives, guide decisions, and drive measurable improvements in performance.

Cross-Functional Influence

Aligns stakeholders across clinical, operational, and external teams to achieve shared quality goals.

Execution Excellence

Ensures disciplined, consistent execution of workflows and initiatives to deliver reliable, high-quality outcomes.

Success Profile

• Owns the number and delivers results
• Makes clear decisions and prioritizes effectively
• Drives accountability across teams without direct authority
• Translates strategy into execution that scales