Quality Tracker I

GUIDEWELL SANITAS I LLC; United States; Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

GUIDEWELL SANITAS I LLC is seeking a Quality Tracker to support clinical quality processes across our U.S. operations. The role emphasizes monitoring HEDIS/STARs, closing quality gaps, and producing comprehensive analytics for population, provider, and patient levels.

The ideal candidate has 2–3 years in healthcare, strong Excel skills (PivotTables, VLOOKUP), and clear, professional communication. This is a hybrid position with some in-office requirements and cross-functional collaboration.

Qualifications

• High School graduate or equivalent.
• 2–3 years of experience in the medical field.
• Strong knowledge of Microsoft Excel, PivotTables and VLOOKUP.
• Excellent written and verbal communication skills.

Responsibilities

• Proactively monitor quality measures including HEDIS and Medicare STARs.
• Identify and track quality gaps over time and generate reports.
• Assist with medical records requests and test result uploads.
• Support data integrity and participate in NCQA quality metric closures.
• Provide education to providers and staff on NCQA metrics.

Skills

Microsoft Office

Excel (PivotTable, VLOOKUP)

Excellent communication

ECW knowledge

Availity knowledge

Education

High School diploma or equivalent

Tools

ECW

Availity

Job description

“Sanitas is a global healthcare organization expanding across the United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness.”Job SummaryQuality trackers assist and provide information related to the clinical quality process. They make sure companies follow compliance requirements based on the payer contract. They improve processes, assist with supplemental data, and generate reports and document QA systems. They might also train other team members in quality assurance. A Quality Tracker follows all the Sanitas measures of processes, experiences and/or outcomes of patient care, observations or treatment that relate to one or more quality aims for health care such as effective, safe, efficient, patient-centered, equitable, and timely care. Trackers provides comprehensive reporting and analytics at population, provider, and patient level. Our solution allows a health plan to track performance measurement of quality measures across Commercial, Medicare, and Medicaid lines of business including HEDIS, STARs, and state-specific Medicaid measures. The Quality Tracker provides robust solutions to help overcome challenges associated with HEDIS compliance based on benchmark across – providers, practices, organizations, etc.Essential Job FunctionsReasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Proactive and continuous monitoring of quality measures including HEDIS and Medicare STARs.Identification and tracking of quality gaps across time. Comprehensive analytics for tracking trends by measure. HEDIS measure tracking, reporting, and submission.Help with medical records requests.Request test results. Assist obtaining reports and upload the test in the patient chart. Assistant with supplemental data. Training other groups about quality measures and best practices.Proactive participation in the closure of the quality HEDIS/START metric.Review the quality metric, identify the action needed to close it. If required, place the standing order, assist in the referral process, communicate with the patient to notify them of the action, and schedule an appointment.Proactive participation in patient outreach.The quality tracker should support patient outreach and appointment assignment.Education to the essential team including providers, CCA, pre-visit team and others.The quality tracker should be able to educate about all the NCQA quality metrics inclusions and share that information with the required personnel. Education sessions could be scheduled on-site in the centers, corporate office, or virtually.Supervisory ResponsibilitiesThis position has no supervisory responsibilities.Required EducationHigh School graduate or equivalent.Required Experience2-3 years in the medical field.Required Licenses and CertificationsN/ARequired Knowledge, Skills, and AbilitiesMicrosoft office and Excel proficiency (Reports, PIVOT table, and Vlookup).Excellent communication skills.ECW knowledge.Availity knowledge (non-essential)Hybrid position: a minimum of 2 days in the corporate office/assigned facility, 8-hour shifts.Preferred QualificationsN/AFinancial ResponsibilitiesThis position does not currently handle physical money or negotiates contracts.N/ABudget ResponsibilitiesThis position does not have budget responsibilities.N/ALanguagesEnglishAdvancedSpanishPreferredCreolePreferredTravelRequiredFlexible to travel between facilities per business needs.Physical DemandsThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.While performing the duties of this job the employee is regularly required to work standing up, walk, use hands to operate tools and equipment and must be able to exert regularly up to 10 pounds of force, frequently exert 30 pounds of force and occasionally exert 50 pounds of force to constantly perform the essential job functions. The employee will be frequently required to reach with hands and arms, bend, balance, kneel, crouch, crawl, push, and pull. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.Environmental ConditionsInside: The employee is subject to environmental conditions, protection from weather conditions but not necessarily from temperature changes. The worker is subject to noise; there may be sufficient noise to cause the worker to shout in order to be heard above ambient noise level.Physical/Environmental ActivitiesPlease indicate with an X the frequency for the activities that apply to the essential functions of the job based on the chart below. Please select Not Required for physical demands that aren’t essential to job performance.Working ConditionNot RequiredOccasionally(1-33%)Frequently(34-66%)Constantly(67-100%)Must be able to travel to multiple locations for work (i.e.travel to attend meetings, events, conferences).XMay be exposed to outdoor weather conditions of cold,heat, wet, and humidity.XMay be exposed to outdoor or warehouse conditions of loudnoises, vibration, fumes, dust, odors, and mists.XMust be able to ascend and descend ladders, stairs, or other equipment.XSubject to exposure to hazardous material.X