abby-care - Senior Manager, Clinical Quality

• Quality Program Architecture & Scaling • Design, implement, and evaluate Abby Care’s multi-state Clinical Quality Improvement (CQI) and Quality Assurance (QA) programs. • Partner closely with state Directors of Nursing and Clinical Leads to standardize clinical practices across all active and upcoming markets. • Build a deeply rooted organizational culture that prioritizes patient safety, exceptional care, and caregiver compliance. • Regulatory Compliance & Audit Readiness • Serve as the internal subject matter expert on state-specific Medicaid paid family caregiving regulations, Electronic Visit Verification (EVV), and Home Health Agency (HHA) scope of practice. • Maintain and guarantee perpetual audit-readiness for state Departments of Health (DOH), CMS, and commercial payer reviews. • Deliver targeted remediation training and policy updates to clinical leadership when compliance gaps or regional regulatory updates occur. • Clinical Documentation & Utilization Review • Oversee corporate charting standards and multi-state clinical audit frameworks. • Establish performance benchmarks for electronic charting, ensuring clinical necessity is robustly documented to protect authorization utilization and minimize compliance risk. • Analyze complex clinical data and Key Performance Indicators (KPIs), including patient readmission rates, extended visit trends, and clinical incident reports, to drive meaningful interventions and workflow improvements. • Incident Management & Mitigation • Oversee the formal escalation, investigation, and reporting of all critical incidents across operations. • Ensure thorough Root Cause Analyses (RCA) are completed for variances and promptly deploy sustainable Corrective Action Plans (CAPs).