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