Quality Improvement Specialist - HEDIS & CMS Stars

Astrana Health; California (MO); Hybrid; USD 31,684 - 45,460; Full time

Job summary

A healthcare organization is seeking a Quality Care Improvement Specialist to enhance quality care across its network in Southern California. The ideal candidate has a Bachelor’s degree, strong analytical skills, and experience in managed care. The role involves partnering with provider offices, analyzing data, and conducting training sessions. Knowledge of HEDIS and the ability to travel 25% are key requirements. This is a full-time position with a hybrid work environment, offering competitive hourly pay.

Qualifications

• 3–5 years of experience in healthcare, ideally in IPA/MSO/Health Plan environments.
• Minimum of 1 year of HEDIS-related experience.
• Independent transportation and ability to travel up to 25% as needed.
• Demonstrates initiative and creativity.

Responsibilities

• Partner with provider practices to improve performance on quality care measures.
• Collect, review, and validate medical records for reporting purposes.
• Analyze provider performance data and deliver targeted education.
• Conduct training for PCPs and specialists on quality metrics.

Skills

Fluent in Spanish

Fluent in Chinese (Mandarin/Cantonese)

Excellent analytical skills

Communication skills

Presentation skills

Strong knowledge of managed care

Collaborative mindset

Education

Bachelor’s degree or equivalent experience

Job description

A healthcare organization is seeking a Quality Care Improvement Specialist to enhance quality care across its network in Southern California. The ideal candidate has a Bachelor’s degree, strong analytical skills, and experience in managed care. The role involves partnering with provider offices, analyzing data, and conducting training sessions. Knowledge of HEDIS and the ability to travel 25% are key requirements. This is a full-time position with a hybrid work environment, offering competitive hourly pay.