Altais

Clinical Quality Advisor

Posted on

August 15, 2025

Job Type

Full-Time

Role Type

Clinical Operations

License

RN

State License

California

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Company Description

At Altais, we’re on a mission to improve the healthcare experience for everyone—starting with the people who deliver it. We believe physicians should spend more time with patients and less time on administrative tasks. Through smarter technology, purpose-built tools, and a team-based model of care, we help doctors do what they do best: care for people. Altais includes a network of physician-led organizations across California, including Brown & Toland Physicians, Altais Medical Group Riverside, and Family Care Specialists. Together, we’re building a stronger, more connected healthcare system.

Job Description

Are you looking to join a fast-growing, dynamic team? We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients. The Clinical Program Manager III is responsible for leading and participating in multi-departmental and cross-functional committees, supporting quality improvement initiatives, analyzing performance data, and developing improvement activities based on industry best practices. This role requires collaboration with various internal departments and external stakeholders to enhance program delivery and efficiency.

Requirements

Bachelor’s degree or equivalent experience. Advanced degree in a related field preferred. RN/LVN preferred Minimum 7 years of prior relevant experience in managed care quality improvement, care management or clinical program management in a clinical/healthcare environment Managed Service Organization (MSO)/Independent Practice Association (IPA) or Health Plan population health management or quality experience Working knowledge of HEDIS, CAHPS, HOS, CMS Medicare Star Ratings, P4P programs, CMS quality withhold, Managed Care Accountability Set (MCAS) and NCQA Quality Improvement standards Epic Experience preferred Experience with ICD-10, CPT, CPT II and HCPCs codes preferred Strong Analytical and Problem-Solving Skills: Expertise in analyzing medical records, extracting data, and applying knowledge to improve quality and healthcare outcomes. Clinical Processes and Healthcare Operations: Strong knowledge of clinical processes and some experience with payer, provider, or hospital operations. Performance Improvement Methodologies: Proficient in using project management techniques, tools of continuous improvement, and work process redesign. Data Translation and Insight Generation: Ability to translate complex data into meaningful insights and actionable recommendations. Basic computer skills, including proficiency in Outlook and Microsoft Office products and ability to navigate various software programs with instruction. Collaboration and Teamwork Skills: Proven ability to collaborate with patients, providers, and internal teams to achieve optimal healthcare outcomes. Project and Program Management Expertise: Skilled in managing clinical programs, quality improvement initiatives, and projects, with strong time management skills. Organizational Skills: Excellent ability to set priorities, manage multiple projects, and work well under pressure. Adaptability: Highly adaptable to changing and challenging situations, demonstrating strong problem-solving and innovative thinking. Influencing and Negotiating Skills: Effective at influencing stakeholders and negotiating to achieve desired outcomes.

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Responsibilities

Targeted Improvement Activities: Collaborate with team members to develop targeted improvement activities based on current outcome performance and industry best practices aimed at enhancing CMS Star Ratings, HEDIS, CAHPS, HOS, P4P, and other performance measures. Research and Integration: Research evidence-based practices, national and regional benchmarks, and industry standards, integrating findings into quality improvement initiatives to ensure alignment with best practices. Continuous Monitoring and Feedback: Perform ongoing monitoring of improvement activities through routine analysis of measure outcomes, providing meaningful and actionable feedback to management regarding process enhancement. Performance Improvement Methodologies: Effectively utilize and implement performance improvement methodologies to support internal quality initiatives, focusing on rapid-cycle performance improvement for timely and effective results. Quality Improvement Program Maintenance: Participate in the development and maintenance of annual quality improvement program documents and evaluations, ensuring the accuracy and relevance of information. Training and Development: Support the development, upgrade, and delivery of comprehensive quality improvement training programs and problem-solving methodologies/tools for quality improvement teams and other stakeholders, fostering a culture of continuous improvement. Support Intradepartmental Teams: Actively support intradepartmental quality improvement teams, programs, projects, and initiatives, ensuring alignment with organizational goals and objectives. Technological Advancement: Continuously seek opportunities to enhance the delivery and efficiency of external-facing quality improvement initiatives through technological advancements and internal process improvements. Data Translation and Recommendations: Translate complex data into meaningful information, draw conclusions, and relate findings to industry standards. Provide informed recommendations to departmental stakeholders and the Quality Improvement Leadership Team regarding performance gaps, program implementation, and performance outcomes. Report Preparation and Data Analysis: Prepare comprehensive reports, conduct detailed data analysis, and create other materials for presentation to committees and management, ensuring clear communication of findings and recommendations. Program and Process Improvements: Actively contribute to the continuous improvement of programs and processes, setting and achieving operational targets within the job area and recommending system/process enhancements to solve problems or improve effectiveness. Program Monitoring and Continuous Improvement: Monitor programs from initiation through delivery, ensuring continuous improvement across projects. Partner with business sponsors to define success metrics and criteria, assess and resolve high-priority program risks, and ensure adherence to project methodology compliance standards. Stakeholder Briefings and Governance: Serve as a subject matter expert, regularly briefing key stakeholders on various aspects of assigned initiatives. Represent the program in project governance and inter-departmental forums, defining and tracking program milestones while developing, maintaining, and reporting on an integrated delivery plan. Operational Targets and Problem Solving: Work to achieve operational targets within the job area, independently managing moderately complex projects/assignments and seeking guidance on higher complexity tasks. Communicate effectively within the department to provide and obtain information, requiring some explanation or interpretation to reach agreement. Provide guidance to entry-level professionals and support employees, ensuring practical knowledge and experience are shared for continuous improvement. Committee Participation and Leadership: Lead and actively participate in multi-departmental and cross-functional committees and external stakeholder workgroups, to support key quality improvement initiatives. Audit Participation and Process Improvement: Participate in audits as required and contribute to the development and implementation of corrective processes to meet audit requirements and enhance clinical performance, quality, and care management.

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