Bilingual HEDIS Quality Specialist

Suvida Healthcare; Tucson (AZ); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Competitive Pay

Free Mental Health & Life Coaching for

Holiday Time Off with Pay

Paid Community Service Day

Paid Parental/Family Leave

Generous Paid Time Off (PTO)

401k Retirement Plan with CompanyMatch

Job summary

Suvida Healthcare is seeking a Quality Specialist to partner with our clinical teams to identify care gaps, capture HEDIS documentation, and audit records across our primary care program serving Medicare-eligible Hispanic seniors in Arizona.

The role requires 4+ years in value-based care, 2+ years of HEDIS experience, CMS STARS knowledge, and strong Excel skills. Travel up to 10% within Arizona; join a diverse, mission-driven team dedicated to health equity and high-quality patient care.

Qualifications

• 4+ years of experience in value-based care settings (primary care or Medicare Advantage).
• 2+ years of HEDIS or Risk Adjustment experience in supplemental data and chart reviews.
• Knowledge of CMS STARS program.
• Basic understanding of billing and claims coding.
• Experience reviewing Electronic Medical Records.
• Proficient use of Microsoft Excel, Word and PowerPoint.
• At least 1 year of experience using medical terminology.

Responsibilities

• Identify gaps in care and notify clinical staff of next steps.
• Submit documentation to payer portals to close quality gaps.
• Audit supplemental data for compliance with identified measures.
• Educate staff and providers on HEDIS specifications.
• Collaborate with departments on quality projects and goals.
• Participate in daily huddles and support staff with time-sensitive measures.

Skills

Independent work

Problem solving

Multitasking

Adaptability

Education

Bachelor's degree in healthcare administration or public health

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Suvida Healthcare is seeking a Quality Specialist to partner with our clinical teams to identify care gaps, capture HEDIS documentation, and audit records across our primary care program serving Medicare-eligible Hispanic seniors in Arizona.

The role requires 4+ years in value-based care, 2+ years of HEDIS experience, CMS STARS knowledge, and strong Excel skills. Travel up to 10% within Arizona; join a diverse, mission-driven team dedicated to health equity and high-quality patient care.