Clinical Quality & Adherence Programs (46741)

General Purpose: Clinical Quality & Adherence Programs, Manager is s a clinically focused leader responsible for driving medication optimization and CMS quality measure performance through direct provider outreach, clinical collaboration, and targeted intervention strategies. They will be managing all MCM daily operations, including creating and directing strategies and collaborating with other teams and departments to produce ever increasing results. Responsible for coaching and developing the MCM team to meet and exceed established goals, ensuring adherence to business processes and policies, and creating a positive, competitive, challenging and results-oriented working environment. Provide leadership, direction, guidance, and support to all MCMs in a manner consistent with AdhereHealth core values and business objectives. This role combines hands-on clinical work (including provider discussions and care gap resolution) with operational oversight of clinical staff (e.g., MCMs, MAs) supporting adherence and medication quality initiatives. The manager serves as a clinical subject matter expert across CMS quality measures, with a primary focus on Osteoporosis Management in Women (OMW) and additional medication safety and optimization measures. The manager partners closely with internal clinical, operations, training, and client teams to ensure interventions are clinically appropriate, operationally scalable, and aligned with client performance goals. Essential Duties & Responsibilities: • Manage MCMs to ensure program(s) productivity, quality and consumer satisfaction/client performance objectives are met and performed in an efficient manner • Identify trends in call data for clinical services team and assess patterns and make recommendations to improve operational performance. Provides operational oversight to support consistent achievement of performance expectations • Prioritize team goals and individual goals to effectively achieve business objectives • Communicate client and company goals and metrics with team members to deliver a high level of customer service and productivity • Supervise and monitor ongoing performance of team members. Continually examine team performance against department standards and conduct regular performance reviews and one-on-one meetings with direct reports to evaluate performance • Manage special projects • Participate in interviewing, hiring, and training of MCM team members. • Analyzes daily call-center reports and drive daily/weekly/monthly KPI standard • Provide regular feedback to VP Clinical Operations and other members of the management team regarding current operational performance • Manage escalated issues, working with other departments, identifying the root cause and implementing a plan for remediation and presentation of future issues • Collaborate with Health Services Training Team to develop comprehensive training program and maintain training materials to ensure that call center staff receives high quality technical and soft-skills training Clinical & Provider Engagement • Conduct direct provider outreach to discuss and resolve medication-related care gaps, including: • Osteoporosis Management in Women (OMW) • Guideline-directed therapy in chronic conditions Medication safety initiatives (drug-drug interactions, high-risk medications for falls, inappropriate therapies) • Serve as a clinical liaison with provider offices, presenting evidence-based recommendations in a collaborative, non-directive manner. • Support clinical documentation, provider follow-up, and appropriate closure of care gaps in alignment with CMS and client requirements. Program & Operational Oversight • Oversee day-to-day execution of clinical adherence and quality programs, ensuring productivity, quality, and performance targets are met. • Provide functional oversight and clinical guidance to MCMs, and other clinical support staff engaged in medication optimization initiatives. • Identify trends in clinical and outreach data to inform workflow improvements, prioritization strategies, and intervention effectiveness. • Translate quality measure requirements into clear, executable workflows for frontline clinical staff. • Partner with internal stakeholders to refine outreach strategies as measures, client priorities, or regulatory guidance to evolve. Leadership Duties (If Applicable) • Establish positive partnerships across business groups both inside and outside of the organization • Provide leadership to others through example and sharing of knowledge/skill • Provide strong, dynamic leadership that mentors, develops, and guides MCM staff to achieve overall department success People Management • Coach, mentor, and develop clinical staff through regular one-on-ones, performance feedback, and targeted skill development. • Partner with the AdhereHealth leadership and human resources to execute strategic recruiting and employee engagement programs to attract and retain top performers • Suppor