Quality Improvement Specialist
Core
Connect patients, provider practices, and internal teams to identify, manage, and close quality gaps through targeted education, outreach, and data-driven collaboration in a value-based care environment.
Role type
Quality Improvement Specialist (Healthcare Operations)
Builds
Actionable performance insights and improved HEDIS/Medicare Stars measure outcomes for nephrology and primary care practices.
Domain
Healthcare / Value-Based Care / Nephrology
Deliverable
Dashboards & analysis
Required skills
Patient-facing outreach, quality workflows, gap closure processes, documentation requirements, EMR proficiency, MS Office Suite
Preferred skills
HEDIS and Medicare Stars measures, nephrology/CKD/ESRD experience, Medical Assistant or LPN license
Technologies
EMRs, Outlook, Teams
Responsibilities
Serve as a trusted partner to practices on HEDIS and Stars expectations; Share and interpret quality reports and care gap lists; Educate provider practices on documentation accuracy and best practice workflows; Facilitate recurring meetings to review quality trends and co-develop action plans; Manage an assigned patient panel and conduct proactive outreach to close care gaps; Collaborate with cross-functional teams to ensure payer-aligned support.
Seniority
Individual Contributor, 1-2 years experience
