Senior Director, Clinical Training & Quality
Alignment Health
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $172,364 - $258,547 per year
Job Level
About the role
- Provide enterprise leadership for internal clinical quality oversight, performance monitoring, and workforce training across a national Medicare Advantage health plan
- Build and lead an internal clinical quality audit function focused on evaluating employee performance, clinical decision-making, documentation, and adherence to policies and workflows
- Establish audit methodologies, sampling approaches, scoring criteria, and reporting standards to assess quality and consistency of internal clinical work
- Conduct routine and targeted audits across clinical and operational roles (e.g., care management, utilization management, clinical reviews)
- Identify performance gaps, patterns of non-adherence, and operational risks; perform root cause analyses to distinguish training, process, and system issues
- Develop, implement, and oversee corrective action plans (CAPs) tied to audit findings, including retraining, workflow changes, and performance monitoring
- Track corrective action effectiveness and ensure sustained improvement through follow-up audits and trend analysis
- Own the enterprise clinical quality training strategy aligned to audit findings, regulatory requirements, and operational priorities
- Design and implement role-based, competency-driven training programs that translate clinical standards and policies into practical, repeatable execution
- Lead development of standardized curricula, onboarding programs, refresher training, job aids, and performance support tools
- Ensure training programs are embedded into day-to-day operations and reinforced through leadership coaching and performance management
- Partner with Learning & Development to leverage adult learning principles, delivery modalities, and learning management systems
- Integrate audit results and training outcomes into a continuous feedback loop to drive performance improvement
- Collaborate with Clinical Operations, Compliance, Human Resources, and Analytics teams to align performance monitoring, training, and corrective action efforts
- Present audit findings, performance trends, and improvement plans to senior leadership
- Define success metrics for audit performance, training effectiveness, and corrective action outcomes
- Develop dashboards and reporting to monitor trends, risks, and improvement over time
- Lead, mentor, and develop a team of quality auditors, trainers, and clinical subject matter experts
Requirements
- 10+ years of experience in clinical quality, healthcare operations, or performance management within Medicare Advantage or managed care
- Demonstrated experience auditing internal clinical or operational performance and leading corrective action efforts
- Proven success designing and implementing large-scale training programs tied to performance outcomes
- Strong understanding of Medicare Advantage regulations and internal quality oversight expectations
- Bachelor's degree required; advanced degree in Nursing, Public Health, Healthcare Administration, or related field preferred
- Active clinical license (e.g., RN, NP, PA, MD/DO) preferred
- Experience building internal quality monitoring or workforce performance programs
- Background in care management, utilization management, or clinical operations
- Familiarity with adult learning theory, coaching models, and performance remediation
- Experience working in highly regulated healthcare environments
Benefits
- Health insurance
- 401(k) retirement plans
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical quality oversightperformance monitoringaudit methodologiesroot cause analysiscorrective action planstraining program designdashboard developmentperformance managementquality auditingclinical decision-making
Soft Skills
leadershipcollaborationmentoringcoachingcommunicationorganizational skillsanalytical skillsproblem-solvingadaptabilitystrategic thinking
Certifications
active clinical licenseRNNPPAMDDO