Quality Improvement Spec III - CA

Health Services Advisory Group, Inc. (HSAG); United States; On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

401(k)

Tuition assistance

Disability insurance

Job summary

A leading healthcare organization is seeking a Quality Improvement Specialist to enhance services provided to Medicare beneficiaries. In this vital role, you will support healthcare providers to improve quality and safety by utilizing evidence-based interventions and coaching. Ideal candidates hold a Bachelor's degree and RN, with significant experience in the healthcare sector. Strong analytical and communication skills are essential for success in this position.

Qualifications

• Bachelor's degree required; master's degree preferred.
• RN degree required (LPN or RN).
• Minimum of 7 years of experience in a healthcare-related field including QI experience.

Responsibilities

• Support CMS Quality Improvement Program with technical assistance.
• Deliver quality improvement education and resources.
• Analyze clinical and operational data to identify performance gaps.

Skills

Communication

Data Analysis

Project Management

Education

Bachelor's Degree

RN Degree

Tools

Microsoft Office

SharePoint

Job description

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Under supervision of the Director, the Quality Improvement Specialist (QIS) supports the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) Program by providing hands-on technical assistance and quality improvement (QI) support to healthcare providers-primarily nursing homes, hospitals, and physician practices. The QIS collaborates with providers to assess performance, conduct root cause analyses, and co-develop Quality Action Plans (QAPs) aligned with CMS priorities. This position plays a vital role in driving the adoption of evidence-based interventions, guiding providers through regulatory requirements, and helping them improve safety, care quality, and outcomes for Medicare beneficiaries through onsite visits, virtual coaching, and educational outreach.

Core Competencies and Responsibilities

Summary

Under supervision of the Director, the Quality Improvement Specialist (QIS) supports the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) Program by providing hands-on technical assistance and quality improvement (QI) support to healthcare providers-primarily nursing homes, hospitals, and physician practices. The QIS collaborates with providers to assess performance, conduct root cause analyses, and co-develop Quality Action Plans (QAPs) aligned with CMS priorities. This position plays a vital role in driving the adoption of evidence-based interventions, guiding providers through regulatory requirements, and helping them improve safety, care quality, and outcomes for Medicare beneficiaries through onsite visits, virtual coaching, and educational outreach.

Core Competencies and Responsibilities

Provider Engagement and Relationship Management

• Serve as the primary contact for assigned providers to promote participation and secure Provider Service Agreements.
• Build and sustain collaborative relationships with providers and stakeholders to foster long-term engagement.
• Clearly communicate complex healthcare and QI concepts via meetings, teleconferences, and written correspondence.
• Refer inquiries appropriately and consult with supervisors and internal teams, when needed.

QI and Technical Assistance

• Apply evidence-based QI methodologies to conduct comprehensive assessments, perform root cause analyses, and deliver technical assistance aligned with CMS project goals and metrics.
• Develop customized Quality Action Plans (QAPs) grounded in evidence-based interventions and recognized best practices.
• Collaborate with internal teams and external stakeholders to implement effective QI interventions.
• Deliver QI education, resources, and training to healthcare providers and stakeholders.

Data and Reporting

• Analyze clinical and operational data to identify performance gaps, interpret trends, and guide providers in implementing targeted QI strategies.
• Provide tailored technical assistance through data analysis, QI coaching, and coordination of relevant resources.
• Promptly and accurately document project activities, site visits, provider communications, and outcomes using HSAG and CMS-approved systems.

Professional Development and Compliance

• Maintain up-to-date knowledge of QI methodologies, tools, and best practices through continuous professional development.
• Stay current on best-practice guidelines and regulatory updates from CMS, the Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), and other regulatory agencies.

Project Execution and Team Collaboration

• Manage multiple initiatives, deadlines, and deliverables with strong organization and accountability.
• Contribute to the development of tools, educational content, reports, and other deliverables in a team environment.
• Effectively shift strategies and support approaches to align with evolving program goals, regulatory updates, and emerging challenges in the healthcare environment.
• Occasionally work extended hours to meet project deadlines.

Position Level Qualifications

• Bachelor's degree required; master's degree preferred.
• RN degree required (LPN or RN).
• Prior Director of Nursing (DON) required.
• Minimum of 7 years of experience in a healthcare-related field, including QI experience.

Scope of Responsibility

• Demonstrates strong knowledge of CMS QIN-QIO core quality measures.
• Interprets data to identify trends and recommends system-level improvements.
• Uses advanced QI tools and methodologies to conduct assessments, identify root causes of performance issues, and guide evidence-based interventions to improve quality.
• Oversees quality efforts for a larger or more complex group of providers.
• Coaches and supports QIS I and II staff.
• Designs materials and resources for stakeholders and providers for director-level review.
• Represents the organization in external meetings and collaboratives.
• Independently develops and implements QAPs with providers.
• Contributes to completion of CMS reports, deliverables, and ad hoc requests, as assigned.
• Advises supervisors on complex quality issues and performance improvement opportunities.
  

Other Qualifications

• Working knowledge of Microsoft Office, SharePoint, or similar productivity and customer relationship management (CRM) systems is preferred.
• Strong written and verbal communication skills, including experience delivering presentations, conducting training, and engaging with providers via phone and email.
• Commitment to improving healthcare quality, safety, and outcomes for Medicare beneficiaries.
• Detail-oriented with strong initiative, sound judgment, and the ability to manage multiple priorities independently.
  

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer

This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts, or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, workload, rush jobs requiring non-regular work hours, or technological developments).

HSAG is an EEO Employer of Veterans protected under Section 4212.

If you have special needs and require assistance completing our employment application process, please feel free to contact us.

EOE M/F/Veteran/Disability

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider and Quality Assurance

• Industries

  Home Health Care Services, Hospitals and Health Care, and Hospitals

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Tuition assistance

Disability insurance

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