Quality Manager – Colonial Healthcare
Location: Sumter, SC
Job Category: Medical & Clinical Operations
Requisition Number: 2301661
Estimated Salary: $71,200 – $127,200 per year
About the Role:
Colonial Healthcare, a part of UnitedHealth Group’s OptumCare, is seeking a Quality Manager to lead and oversee quality improvement programs, care coordination strategies, and value-based care performance for its expanding network across South Carolina. Reporting to the VP of Operations, the Quality Manager will be instrumental in maintaining the Patient-Centered Medical Home (PCMH) model and driving improvements across HEDIS, CAHPS, Stars, ACO, and MIPS metrics.
Key Responsibilities:
Manage and oversee performance on HEDIS, Stars, PCMH, CAHPS, ACO, and MIPS metrics across the organization.
Lead patient outreach workflows, ensuring timely engagement for preventive services and gap closures.
Oversee compliance and performance across full-risk and Pay-for-Performance (P4P) programs across Medicare, Medicaid, and Commercial lines.
Develop workflows for data collection, audits, reporting, and clinical outcomes related to PCMH.
Ensure continuity of care post-hospitalization or emergency department visits.
Coordinate with IT and Analytics to automate supplemental data submissions to payers.
Identify quality trends and develop strategies for continuous improvement.
Supervise a dedicated team focused on healthcare quality measures.
Coordinate and complete medical records requests while maintaining HIPAA and regulatory compliance.
Required Qualifications:
High school diploma or equivalent
Active certification or licensure in a clinical field (CMA, LPN, Radiologic Technologist, etc.)
5+ years of management or supervisory experience
Strong knowledge of quality-based care metrics including HEDIS
Familiarity with chronic disease management and population health strategies
Experience with Electronic Health Records (EHRs) and disease registries
Excellent leadership, communication, and organizational skills
Willingness to travel up to 50% to local clinics (must have Driver’s License and reliable transportation)
Preferred Qualifications:
Bachelor’s degree in Nursing, Public Health, Healthcare Administration, or related field
2+ years of management experience within a group medical practice
Proven success in building and retaining high-performing teams
Strong understanding of performance-driven incentive programs
Why Join Us?
At Colonial Healthcare, your role goes beyond managing metrics—you’ll drive meaningful, patient-centered quality improvements that support healthier lives. Be part of a forward-thinking team focused on transforming care delivery and optimizing outcomes through strategic, data-driven leadership.
Benefits Include:
Comprehensive medical, dental, and vision insurance
Incentive and recognition programs
401(k) plan with employer contributions
Employee stock purchase plans
Paid time off and continuous development support
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