General Manager Quality

RESPONSIBILITIES

• Lead and drive overall quality strategy across end-to-end RCM functions
• Define and implement quality frameworks, SOPs, and audit mechanisms aligned with client and regulatory standards
• Ensure compliance with CMS, HIPAA, provider guidelines, and industry regulations
• Establish strong governance models, KPIs, and quality scorecards for performance tracking
• Drive continuous quality improvement initiatives using RCA, Six Sigma, and Lean methodologies
• Identify trends in denials, errors, and audit failures and implement corrective actions
• Manage internal & external audits, ensuring audit readiness and compliance adherence
• Partner with operations teams to reduce rework, improve accuracy, and enhance first-pass yield
• Lead client quality reviews (QBRs) and act as the point of contact for quality-related escalations
• Ensure client SLA adherence, service excellence, and long-term retention
• Build and manage high-performing QA teams, including hiring, training, and capability development
• Drive a culture of quality ownership, accountability, and continuous improvement
• Leverage automation, analytics, and AI tools to improve quality monitoring and predictive insights
• Work closely with leadership on strategic initiatives, process transformation, and cost optimization

COMPETENCIES, SKILLS, AND OTHER REQUISITES

• Service Delivery Leadership
• Strategic Thought leadership to grow business.
• External and Internal Stakeholder Management
• Problem Solving and Analytical Skills
• Unflinching integrity and personal work ethics
• Self-starter who strives for self and team excellence
• Attention to detail and concern for accuracy.
• Excellent time management skills and multi-tasking ability
• Excellent written and spoken English.

PROFESSIONAL BACKGROUND

• Minimum 15 years of experience in US Healthcare (RCM - AR Operations/End to End RCM ) Experience is must.
• Must have experience in Quality