Job Description

As a healthcare organization dedicated to improving health outcomes for the Central Coast community, our client is seeking an experienced and mission-driven professional to join their Quality team. The ideal candidate will bring strong regulatory expertise, strategic thinking, and a passion for advancing quality, equity, and population health initiatives.

The Practice Transformation Strategist partners closely with internal teams, provider networks, and community organizations to support quality improvement, practice transformation, and population health initiatives. This role ensures compliance with NCQA, DHCS, and CMS requirements while serving as a subject matter expert on regulatory standards, accreditation readiness, and value-based care models.

Key Responsibilities:

• Partner with cross-functional teams and provider networks to implement practice transformation and quality improvement initiatives that improve patient outcomes
• Ensure ongoing compliance with NCQA, CMS, and DHCS regulatory and accreditation requirements
• Serve as a subject matter expert for quality, population health, and value-based care programs
• Support the design, execution, and monitoring of quality improvement and population health initiatives, including CalAIM-aligned programs
• Develop and support corrective action plans to address regulatory, accreditation, or performance gaps
• Monitor accreditation readiness activities and escalate compliance risks as needed
• Collaborate with IT and internal teams to develop reporting and data-driven solutions
• Prepare and submit required documentation and reports to regulatory and accrediting agencies
• Support Medicare Star Ratings–aligned initiatives
• Provide guidance, education, and support to internal teams and provider partners
• Participate in internal and external stakeholder meetings as needed

Qualifications:

• Strong knowledge of managed care operations, regulatory compliance, and quality performance monitoring
• In-depth understanding of NCQA accreditation standards and quality improvement frameworks
• Experience supporting practice transformation and population health initiatives
• Ability to manage complex projects independently in a fast-paced environment
• Strong analytical, problem-solving, and organizational skills
• Excellent verbal and written communication skills
• Ability to build strong relationships with internal and external stakeholders
• Willingness to travel to provider offices for in-person practice transformation support
• Proficiency in Microsoft Word, Excel, Outlook, and PowerPoint

Education and Experience:

• Advanced degree preferred
• Five (5) years of experience in Medicare and/or Medi-Cal managed care
• Five (5) years of experience working with regulatory or accrediting bodies (NCQA, CMS, DHCS, EQRO)
• Three (3) years of experience in quality improvement or population health
• Experience working in a clinical or healthcare setting

Preferred Qualifications:

• Registered Nurse (RN) license
• Professional certification such as CPHQ or HCC
• Experience with HEDIS and NCQA audit standards
• Knowledge of community-based organizations and social service agencies

Required Skills:

• Strong writing skills

Compensation:

• $104,340 - $156,510

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