Quality Improvement Specialist

Job Description

REQUIREMENTS

• 1-2 years of experience in quality improvement, population health, provider engagement, or care coordination
• Patient-facing outreach experience
• Understanding of quality workflows, gap closure processes, and documentation requirements
• Strong communication and relationship-building skills
• EMR proficiency and familiarity with healthcare technology tools
• Intermediate skills with MS Office Suite including Outlook and Teams
• Home internet supporting minimum 25 Mbps download and 10 Mbps upload
• Dedicated remote workspace lacking ongoing interruptions to protect PHI/HIPAA

Preferred

• Hands-on experience with HEDIS and Medicare Stars measures, including gap identification and closure workflows
• Experience in nephrology, CKD/ESRD, or chronic disease management
• Medical Assistant or LPN license
• Bachelor’s degree in health-related field or equivalent healthcare experience

RESPONSIBILITIES

• Serve as a trusted partner to nephrology and primary/specialty practices on HEDIS and Stars expectations, documentation standards, and value-based care priorities
• Share and interpret quality reports, care gap lists, and dashboards, translating data into practical improvement steps
• Educate provider practices on documentation accuracy, coding completeness, and best-practice workflows impacting HEDIS and Stars performance
• Manage an assigned patient panel, monitoring and prioritizing care gaps across preventive care and chronic disease management
• Conduct proactive patient outreach via phone and electronic channels to educate and motivate completion of screenings, labs, immunizations, and appointments
• Identify and address patient-level barriers such as transportation, scheduling, and health literacy, leveraging internal resources when appropriate
• Collaborate with Quality, Clinical Operations, Coding & Documentation, Practice Transformation, and Pharmacy teams to ensure aligned support
• Maintain accurate, timely documentation in EMRs and quality systems while adhering to HIPAA and regulatory requirements

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