Quality Measure Specialist: HEDIS & CMS Stars

St. Luke's Health System; Boise (ID); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

On-site massages

Employee Assistance Program

Wellness tools

Career development

Job summary

St. Luke’s Health System is seeking a Quality Measure Specialist to advance quality performance and regulatory excellence.

You will drive HEDIS, NCQA, CMS Star Ratings initiatives and validate data from EHRs and care management systems to ensure accurate reporting. You’ll collaborate with providers, vendors, and internal teams to close data gaps, maintain audit-ready docs, and support organizational quality goals.

Qualifications

• Bachelor’s degree or experience in lieu of degree.
• Experience with quality reporting (HEDIS, NCQA, CMS Star Ratings) is preferred.
• Ability to review and abstract clinical data from electronic health records.
• Strong collaboration with providers, vendors, and internal stakeholders.

Responsibilities

• Drive quality measurement and improvement efforts by supporting HEDIS, NCQA, CMS Star Ratings, and other regulatory/performance initiatives.
• Review, abstract, and validate clinical data from electronic health records, medical records, and care management systems to ensure accurate reporting.
• Identify documentation gaps, data discrepancies, and improvement opportunities that affect quality performance and audits.
• Partner with providers, vendors, and internal stakeholders to gather information and resolve data issues.
• Coordinate quality projects, action plans, reporting activities, and deliverables.
• Maintain audit-ready documentation and reporting logs for regulatory reviews and audits.
• Monitor evolving quality measurement requirements and translate changes into operational improvements.
• Contribute to initiatives that enhance measurement accuracy and data reliability.

Skills

Quality measurement

Regulatory compliance

Data abstraction

Cross-functional collaboration

Education

Bachelor’s degree or experience in lieu of degree

Tools

EHR systems

Quality reporting tools

Job description

St. Luke’s Health System is seeking a Quality Measure Specialist to advance quality performance and regulatory excellence.

You will drive HEDIS, NCQA, CMS Star Ratings initiatives and validate data from EHRs and care management systems to ensure accurate reporting. You’ll collaborate with providers, vendors, and internal teams to close data gaps, maintain audit-ready docs, and support organizational quality goals.