Quality Intelligence Program Consultant

Jobgether; United States; Remote; USD 53,000 - 79,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Life insurance

Disability coverage

Paid time off

Retirement plan with employer matching

FSA for healthcare and dependent care

Adoption assistance and parental leave

Educational assistance and training

Remote work option for eligible states

Performance-based pay increases

Job summary

Jobgether is seeking a Quality Intelligence professional to drive enterprise-wide quality measures and reporting. You will monitor regulatory requirements, maintain measure definitions, and lead cross-functional initiatives to improve patient outcomes.

The role requires strong analytical and communication skills, experience with HEDIS/NCQA programs, and the ability to work remotely with diverse teams. This position emphasizes data-driven decision making and collaboration with healthcare

Qualifications

• Bachelor's degree in Healthcare Administration, Project Management, Quality Management, Engineering, or related discipline.
• 5+ years of professional experience in healthcare administration, project management, quality intelligence, quality improvement, or related field.
• Experience with HEDIS and NCQA payer programs preferred.
• Strong understanding of healthcare quality improvement methodologies and performance measurement frameworks.
• Knowledge of project management methodologies and ability to coordinate complex initiatives.

Responsibilities

• Develop and implement enterprise-wide quality and health outcomes measures.
• Monitor external quality reporting programs and regulatory requirements.
• Maintain specifications, measure definitions, and code lists for quality measures.
• Lead development of enterprise-wide reports, workflows, processes, tools, and initiatives.
• Establish processes for accurate quality data collection, analysis, interpretation, and reporting.
• Coordinate interpretation and communication of quality performance data with internal departments and leadership.
• Develop reporting files, databases, and data infrastructure supporting internal and external quality reporting.
• Ensure data accuracy and resolve reporting deficiencies.
• Develop dashboards and data visualizations for clinicians, leaders, and executives.
• Lead Quality Intelligence meetings with stakeholders.
• Monitor payer quality performance metrics and provide insights.
• Serve as SME and collaborate with payer partners.
• Lead system-wide quality improvement initiatives and EHR data capture enhancements.

Skills

Project coordination

Data interpretation

Communication skills

Analytical problem solving

Data visualization

Statistical analysis

Remote collaboration

Education

Bachelor's degree in Healthcare Administration or related field

Tools

Microsoft Office

Excel

PowerPoint

Teams

Job description

Accountabilities:

• Contribute to the development and implementation of enterprise-wide quality and health outcomes measures, definitions, performance goals, improvement initiatives, and cross-functional working groups.
• Monitor external quality reporting programs, industry standards, regulatory requirements, and best practices to ensure internal quality priorities remain aligned with evolving healthcare expectations.
• Maintain programming specifications, measure definitions, and code lists for quality measures used in value-based agreements and internal reporting, coordinating updates with relevant data and technology professionals.
• Lead the development and implementation of enterprise-wide reports, workflows, processes, tools, and initiatives designed to improve healthcare quality and patient outcomes.
• Establish and promote effective processes for accurate quality data collection, analysis, interpretation, and reporting across the organization.
• Coordinate the interpretation and communication of quality performance data with internal departments and leadership teams, translating analytical findings into actionable improvement strategies.
• Participate in the development and maintenance of reporting files, databases, and data infrastructure supporting internal and external quality reporting requirements.
• Ensure the accuracy, consistency, and integrity of quality data through validation activities, including data feed reviews, measure mapping, and identification and resolution of reporting deficiencies.
• Develop accessible and user-friendly quality intelligence solutions, including dashboards, dynamic reports, and data visualizations that provide meaningful insights to clinicians, operational leaders, and executives.
• Lead Quality Intelligence meetings with key stakeholders, facilitating discussions, tracking performance trends, and identifying opportunities to improve quality outcomes.
• Monitor and analyze value-based payer quality performance metrics, identifying improvement opportunities and providing insights to support departmental strategy and decision-making.
• Serve as a primary point of contact and subject matter expert for assigned areas of responsibility, collaborating with internal stakeholders and external payer partners.
• Lead system-wide quality improvement initiatives and develop strategies related to internal and external quality measures, payer data feeds, and reporting requirements.
• Partner with relevant departments and leadership to enhance Electronic Health Record (EHR) tools and improve data capture in support of strategic value-based care agreements.

Requirements:

• Bachelor's degree in Healthcare Administration, Project Management, Quality Management, Engineering, or a related discipline.
• At least 5 years of professional experience in healthcare administration, project management, quality intelligence, quality improvement, or a related field.
• Experience with HEDIS and National Committee for Quality Assurance (NCQA) payer programs is preferred.
• Strong understanding of healthcare quality improvement methodologies, performance measurement frameworks, and continuous improvement tools.
• Knowledge of project management methodologies and the ability to coordinate complex initiatives, manage timelines, and deliver measurable outcomes.
• Proficiency in statistical techniques and analytical methods used to evaluate healthcare performance, interpret trends, and support data-driven decisions.
• Advanced analytical and problem-solving skills, with the ability to interpret complex datasets, identify patterns, draw meaningful conclusions, and validate findings.
• Experience developing reports, graphs, dashboards, and other data visualization materials, as well as maintaining and interpreting statistical information.
• Strong knowledge of healthcare quality measures, reporting requirements, and performance improvement strategies.
• Understanding of value-based agreements, Accountable Care Organizations (ACOs), integrated healthcare operations, and value-based care models.
• Familiarity with CMS quality programs, NCQA HEDIS measures, Medicare Advantage (MA) Star Ratings, and evidence-based clinical guidelines.
• Knowledge of information systems, report programming, quality measure development, and healthcare data management tools.
• Strong project coordination, team facilitation, and meeting management skills, with the ability to engage stakeholders across multiple departments.
• Excellent written and verbal communication skills, including the ability to present complex analytical findings and recommendations to technical and non-technical audiences.
• Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, Outlook, and Teams.
• Ability to work independently, manage competing priorities, and collaborate effectively in a remote, cross-functional environment.
• No specific professional license or certification is required for this position.

Benefits:

• Competitive annual compensation ranging from $38.20 to $57.30 per hour , depending on qualifications, skills, relevant experience, and training.
• Comprehensive medical, dental, and vision insurance.
• Life insurance coverage.
• Short-term and long-term disability benefits.
• Paid time off programs.
• Retirement savings plans with employer matching contributions.
• Flexible Spending Accounts (FSA) for eligible healthcare and dependent care expenses.
• Family-oriented benefits, including adoption assistance and paid parental leave.
• Educational assistance programs to support continued learning and professional development.
• Financial wellness programs and retirement planning support.
• Potential annual compensation increases based on individual performance.
• Additional premium and incentive pay opportunities where applicable.
• Fully remote working arrangement for eligible candidates residing in the following states: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
• Full-time schedule, Monday through Friday, from 9:00 a.m. to 5:00 p.m. Eastern Time.
• 40-hour workweek.
• Opportunities to contribute to meaningful healthcare quality improvement initiatives and advance value-based care strategies.