GDIT is seeking Healthcare Performance & Improvement Lead to support a new Third Party Administrator (TPA) contract by directing quality assurance, performance monitoring, and continuous operational improvement activities. In this role, you will own GDIT’s TPA operational quality oversight function — ensuring performance standards are met, monitored, and reported in accordance with our contractual requirements.

This position will lead recurring compliance and performance assessments, track administrative and clinical trends affecting member health and continuity of care, and drive continuous improvement initiatives aligned with the Program's strategic goals. Through disciplined monitoring, documentation, and audit readiness, you will help ensure the Program consistently meets federal performance expectations and supports high-quality outcomes for its members and stakeholders.

Responsibilities:

• Serve as the GDIT’s primary owner of Quality Assurance (QA) activities while ensuring all contract tasks are performed accurately, consistently, and on time.

• Maintain working mastery of functional and system Acceptable Quality Levels (AQLs), including what is monitored, how monitoring occurs, evaluation methodology, documentation practices, and reporting cadence.

• Coordinate fulfillment of ad hoc information requests from the Program related to performance oversight, audits, or formal reviews, ensuring responses are accurate and delivered on Program-determined timelines.

• Lead regular assessments of Contractor compliance and performance, covering:

  • Compliance with contract requirements, performance standards, and acceptable quality levels.

  • Administrative and clinical trends affecting member health, continuity of care, and stakeholder experience.

  • Alignment with healthcare industry standards and best practices from other federal payers.

• Translate assessment findings into actionable, continuous, proactive improvement initiatives aligned with Program strategic goals and priorities.

• Partner with cross-functional teams (claims, enrollment, clinical, provider network, care coordination) to ensure quality findings inform operational practice.

Required Skills:

• Bachelor's degree with 3+ years of experience in quality management, performance oversight, or compliance roles supporting federal healthcare programs, health plans, or TPAs.

• Strong understanding of healthcare operations, including claims adjudication, enrollment, certification, provider networks, and care coordination.

• Consulting experience in identification and implementation of improvement initiatives with functional teams and business users.

• Experience working within federally regulated environments and supporting programs with high visibility and strict oversight requirements.

• Demonstrated ability to design and lead compliance assessments, trend analysis, and continuous improvement programs.

• Ability to leverage data analysis and reporting tools such as Power BI & Excel to track performance trends and improvement outcomes.

• Strong written and verbal communication skills for stakeholder-facing reporting and audit liaison work.

Preferred Qualifications:

• Experience supporting CDC, CMS, or other federal and/or commercial health programs.

• Experience supporting quality assurance and management during contractor transitions, system implementations, or large operational transformations.

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GDIT IS YOUR PLACE:

• Full-flex work week to own your priorities at work and at home.

• 401K with company match.

• Comprehensive health and wellness packages.

• Internal mobility team dedicated to helping you own your career.

• Professional growth opportunities including paid education and certifications.

• Cutting-edge technology you can learn from.

• Rest and recharge with paid vacation and holidays.

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