Quality Improvement Specialist - Remote

Overview

We are seeking a dedicated Quality Specialist to support Gather Health, an at-risk primary care group for seniors. The ideal candidate will have a strong background in HEDIS and STARs quality metrics and quality program support. This individual will play a critical role in driving improvements in STARs ratings through workflow, reporting, and collaboration with clinical teams and patients to drive exceptional patient outcomes.

In Short

• Work collaboratively with the Quality Manager to perform chart audits and data collection.
• Utilize company resources for chart chase purposes.
• Contact patients for information related to preventive tests.
• Request reports from outside providers or facilities.
• Submit documentation to payers for gap closure.
• Identify opportunities for improvement and provide feedback.
• Utilize tracking tools for daily productivity reporting.
• Attend meetings for quality education or discussions.
• Cross train with Referral Coordination department.
• Maintain up-to-date knowledge of regulatory HEDIS/STARs standards.

Requirements

• Knowledge in managing diverse clinical data and HIPAA rules.
• Experience with various EMR’s, Athena preferred.
• Knowledge and experience in HEDIS/STARS measures (2 years preferred).
• Ability to manage multiple projects and meet deadlines.
• Proficiency in data management tools such as Excel.
• Previous experience in primary care practice preferred.
• Licensed Vocational Nurse or Medical Assistant strongly preferred.

Benefits

• Flexible remote work environment.
• Opportunity to impact patient outcomes positively.
• Collaborative team environment.
• Professional development opportunities.
• Supportive management and staff.