Montage HealthHiring

Director of Health Plan Quality (RN)

  • Remote, worldwide
  • Full-time
  • Lead
  • Posted 4 days ago
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In one line

Nurse leader owning quality strategy for a health plan: STAR ratings, member experience, risk adjustment and appeals oversight.

About the role

Bringing four quality domains under one strategy so clinical outcomes, member satisfaction and risk scores move together for Medicare Advantage and commercial members.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, worldwide
Seniority
Lead
Employment
Full-time
Skills
STAR Ratings, HEDIS, Risk Adjustment, CAHPS, NCQA accreditation
Posted
31 Oct 2026
Last checked
2 Nov 2026

What you will do

  • Lead STAR strategy, including HEDIS, HOS and administrative measures.
  • Own RAF clinical strategy, HCC capture and RADV audit readiness.
  • Provide clinical oversight of appeals and grievances with the operations team.
  • Set KPIs and executive dashboards tying the quality domains together.

What they look for

  • An RN with leadership experience in health plan quality.
  • Deep knowledge of Medicare Advantage quality programs and risk adjustment.
  • Track record with CMS, ERISA and state regulatory requirements.
  • Comfort working across finance, analytics, compliance and customer service.

How Keywordise applies for you

  1. 1Upload your CVAdd your CV once. It takes about a minute.
  2. 2Tailored to this jobKeywordise writes a CV and a cover letter for this job from your real experience.
  3. 3The form fills itselfName, email, experience and screening questions, field by field.
  4. 4Application sentYou get a receipt and follow it in your dashboard.

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ClaudeConnectorChatGPTConnectorMuseby Meta

Claude

  1. In Claude, open Settings, then Connectors, and choose Add custom connector.
  2. Name it Keywordise and paste the connector URL.
  3. Click Connect, log in to Keywordise and approve. Then send the prompt in a new chat.
Connector URL
https://keywordise.com/mcp

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ChatGPT

  1. In ChatGPT, open Settings, then Connectors. On plans that need it, turn on developer mode first.
  2. Add a new connector with the connector URL and choose OAuth. Leave the client ID and secret empty.
  3. Log in to Keywordise and approve. Then send the prompt in a new chat.
Connector URL
https://keywordise.com/mcp

Disconnect any time in your Keywordise settings.

Muse

  1. Open Muse (muse.ai or the app) and send it the message below.
  2. If Muse asks how to sign in, answer OAuth. Open the sign-in link it sends, log in to Keywordise and approve.
  3. Send the prompt. Muse asks before it sends anything.
Message for Muse
Add a custom connector called Keywordise. It is a remote MCP server at https://keywordise.com/mcp and uses OAuth. Give me the sign-in link.

Muse is available in the US only for now.

Prompt
Apply to Keywordise job jyyl6ia4g5
How to connect

Questions about this job

Is this a remote job, and where can I work from?

Yes. The posting lists Director of Health Plan Quality (RN) as a remote role open to candidates worldwide.

What does this job pay?

No pay range is stated in the posting.

What experience is needed?

It is a lead role. The posting asks for: an RN with leadership experience in health plan quality; deep knowledge of Medicare Advantage quality programs and risk adjustment; track record with CMS, ERISA and state regulatory requirements. Skills it names include STAR Ratings, HEDIS, Risk Adjustment, CAHPS.

How do I apply with Keywordise AI?

Press the Apply with Keywordise AI button and add your CV. Keywordise tailors your CV and cover letter to this posting and sends the application for you, with a free 7-day trial and no card.

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