Bilingual Quality Specialist – HEDIS & Care Gap

Suvida Healthcare; Tucson (AZ); On-site; USD 65,000 - 90,000; Full time

Job summary

Suvida Healthcare is seeking a Quality Specialist to collaborate with our clinic staff, identify gaps in care, and ensure accurate HEDIS and risk adjustment reporting. You will audit records, educate teams, and support accurate payer submissions within a fast-paced, mission-driven environment.

Role requires 4+ years in value-based care, familiarity with CMS STARS, and strong data interpretation skills. Arizona residency is expected, with travel up to 10%.

Qualifications

• Bachelor's degree in healthcare administration or public health required.
• 2+ years of experience in value-based care settings preferred.
• 2+ years of HEDIS or Risk Adjustment experience in data/chart reviews.
• Knowledge of CMS STARS program; basic billing understanding.
• Experience reviewing Electronic Medical Records; MS Excel, Word, PowerPoint.

Responsibilities

• Identify and close quality gaps; notify clinical staff of next steps.
• Submit documentation to payer portals to close gaps.
• Audit data for compliance with identified measures.
• Educate staff on HEDIS specifications and resolve inquiries.
• Join daily huddles to inform staff of patients with time‑sensitive measures.
• Collaborate with departments on quality projects to reach goals.
• Work Monday–Friday, in the Arizona area; travel up to 10%.

Skills

Independent work

Problem solving

Multitasking

Adaptability

Education

Bachelor's degree in healthcare administration or public health

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Payer portals

Job description

Suvida Healthcare is seeking a Quality Specialist to collaborate with our clinic staff, identify gaps in care, and ensure accurate HEDIS and risk adjustment reporting. You will audit records, educate teams, and support accurate payer submissions within a fast-paced, mission-driven environment.

Role requires 4+ years in value-based care, familiarity with CMS STARS, and strong data interpretation skills. Arizona residency is expected, with travel up to 10%.