Medical Management Quality & Training Manager (Remote)

POSITION SUMMARY

The Manager, Medical Management Quality & Training leads the Quality and Training function supporting Allieds Medical Management teams. This role develops and maintains onboarding and continuing education programs, oversees quality auditing, analyzes quality and population trends, and converts findings into practical training, process improvements, and stronger client reporting. The manager partners with Medical Management leaders, Client Management, Growth Marketing, and other cross-functional teams to strengthen employee readiness, member impact, and the articulation of Allieds value to clients, brokers, and stop-loss carriers.

ESSENTIAL FUNCTIONS

Lead, coach, and develop the Quality and Training team through clear performance expectations, regular feedback, development planning, and effective resource allocation.

Design, deliver, and maintain structured onboarding and continuing education programs across Medical Management, including training modules, assessments, knowledge checks, practical activities, reference tools, and refresher programs for new and tenured employees.

Partner with department leaders and subject matter experts to standardize core onboarding, identify learning needs, coordinate cross-functional training, and ensure employees have the knowledge and resources needed to succeed.

Oversee quality auditing standards, calibration practices, scorecards, and review processes; guide auditors in translating recurring findings into constructive feedback, team-wide education, and measurable improvements in employee performance and member support.

Analyze audit results, quality metrics, employee feedback, client reporting, case volume, utilization, claims, and population trends to identify systemic gaps and recommend targeted training, workflow, outreach, referral, or process improvements.

Evaluate the effectiveness of quality and training initiatives through competency reviews, assessments, audit outcomes, trend analysis, and stakeholder feedback; adjust programs and priorities as needed.

Ensure impact narratives, value stories, and client reporting consistently and accurately communicate the work completed for members and the value delivered to clients.

Collaborate with Medical Management leadership, Client Management, and Growth Marketing to align quality and training priorities with client needs and to develop approved external materials, case studies, and visuals.

Communicate and advocate for recommendations, including the rationale, anticipated impact, resource needs, and next steps, while balancing priorities across people leadership, training, quality, reporting, and cross-functional projects.

Support the continuous improvement of technology, automation, learning, reporting, and quality-monitoring tools while maintaining applicable internal policies, client requirements, vendor guidelines, and compliance expectations.

Other duties as assigned.

EDUCATION

Bachelors degree or equivalent work experience required.

EXPERIENCE AND SKILLS

5+ years of case management, medical management, quality, training, healthcare operations, or related experience, preferably within a third-party administrator, carrier, or healthcare organization.

At least 3 years of supervisory or people-leadership experience managing and developing employees with varied backgrounds and levels of tenure.

Demonstrated experience conducting or overseeing quality audits, delivering constructive feedback, and translating audit findings or quality scores into practical performance improvements.

Demonstrated experience designing and delivering structured onboarding and continuing education programs, including training modules, assessments, and learning activities beyond job aids or workflow documentation.

Strong analytical and strategic-thinking skills, with the ability to evaluate quality metrics, large data sets, client reports, claims or utilization information, and population trends; identify recurring themes; and develop clear recommendations.

Strong coaching, facilitation, presentation, and communication skills, including the ability to explain complex healthcare and operational concepts, advocate for ideas, and present recommendations to leadership.

Ability to collaborate effectively across Medical Management, Client Management, Growth Marketing, and other internal teams while balancing multiple priorities across people leadership, quality, training, reporting, and project work.

Working knowledge of adult learning principles, instructional design, quality assurance practices, self-funded health plans, third-party administration, and remote or blended learning tools is preferred.

Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook, with the ability to learn reporting, auditing, workflow, and learning technologies.

POSITION COMPETENCIES

Accountability

Analytical Thinking

Coaching and Feedback

Collaboration

Communication and Influence

Customer Focus

Decision Making

Execution Management

People Leadership

Strategic Thinking

Time and Priority Management

PHYSICAL DEMANDS

- This is a standard desk role requiring extended periods of sitting and computer work.

WORK ENVIRONMENT

- Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive .

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.

Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.