Healthcare Quality Specialist

PBACO Holding LLC; Florida; On-site; USD 85,000 - 110,000; Full time

Job summary

PBACO is seeking an ACO Quality Specialist in Florida to manage Medicare, ACO REACH, and commercial quality reporting and drive care-gap closures. You will work with practices and consultants to ensure compliance and improve patient outcomes.

The role requires 3–5 years in healthcare quality, knowledge of CMS measures, and proficiency with Excel and EHR data. A Master’s degree is preferred and a collaborative, results-driven environment is offered.

Qualifications

• Bachelor's degree in Nursing, Public Health, Healthcare Administration (Master's preferred).
• 3–5 years of healthcare quality or performance improvement experience.
• Strong knowledge of CMS ACO measures, HEDIS, STARS, and CAHPS.
• Experience with Lean, Six Sigma, PDSA, or similar methodologies.
• Excellent communication, provider engagement, and training skills.
• Strong data analysis skills with Excel, PowerPoint and Word.

Responsibilities

• Manage day-to-day quality reporting for Medicare, ACO REACH, and Commercial programs.
• Track and close care gaps by distributing and monitoring Gaps-in-Care reports.
• Support data collection, validation, and analysis to identify opportunities for improvement.
• Train and educate providers and staff on quality program requirements and workflows.
• Support CAHPS survey readiness and strategies to improve response rates.
• Participate in payer audits and committee meetings as subject matter expert.
• Collaborate with practices to improve outcomes in diabetes, hypertension, and preventive screenings.

Skills

Quality Improvement

Healthcare Analytics

Data Analysis

Provider Engagement

Training & Education

Education

Bachelor's degree in Nursing, Public Health, Healthcare Administration

Tools

Excel

PowerPoint

Word

EHRs

Job description

About Us:

We are one of the top accountable care organizations (ACO) in the United States. Our company produces and manages proprietary applications, including multiple physician-facing mobile and web apps designed to enhance care coordination for our ACO participants. We are dedicated to driving innovation and excellence in value-based care.

The Opportunity:

We are seeking an ACO Quality Specialist to play a hands‑on role in managing and improving quality programs across Medicare Shared Savings Program (MSSP), ACO REACH, and Commercial payer contracts. This role will support accurate quality reporting, gaps‑in‑care closure, CAHPS survey readiness, and health equity planning. You'll work directly with practices, providers, and consultants to ensure compliance while helping drive measurable improvements in patient care outcomes.

What You'll Do:

• Manage day-to-day quality reporting for Medicare, ACO REACH, and Commercial programs.
• Track and close care gaps by distributing and monitoring Gaps-in-Care reports.
• Support data collection, validation, and analysis to identify opportunities for improvement.
• Train and educate providers and staff on quality program requirements, documentation, and workflow optimization.
• Support patient experience survey readiness (CAHPS) and promote strategies to improve response rates.
• Participate in payer audits and committee meetings, providing subject matter expertise.
• Collaborate with practices to improve outcomes in areas such as diabetes management, hypertension, and preventive screenings.

What We're Looking For:

• Bachelor's degree in Nursing, Public Health, Healthcare Administration, or related field (Master's preferred).
• 3-5 years of healthcare quality or performance improvement experience, preferably in an ACO or value-based care setting.
• Strong knowledge of CMS ACO measures, HEDIS, STARS, and CAHPS.
• Experience in quality improvement methodologies (Lean, Six Sigma, PDSA, etc.).
• Excellent communication, provider engagement, and training skills.
• Strong data analysis skills; proficient in Excel, PowerPoint, and Word.

Preferred Qualifications:

• Certified Professional in Healthcare Quality (CPHQ) or similar credential.
• Clinical background/licensure (RN, LPN) a plus.
• Familiarity with EHRs and healthcare analytics tools.

Why Join PBACO?

• Be part of one of the nation's most successful ACOs.
• Contribute to programs that directly impact patient outcomes and health equity.
• Collaborative and mission-driven team environment.
• Competitive salary and comprehensive benefits package.