NCQA Specialist/ Quality Improvement - Denver Health Medical Plan (* Weekly Hybrid Schedule Requirement *)

About the role

We are recruiting for a mission-driven NCQA Specialist/Quality Improvement - Denver Health Medical Plan. This role requires a weekly hybrid schedule and is based in Denver, Colorado.

Responsibilities

• Ensure compliance with HCPF quality requirements, including performance improvement projects (PIPs), External Quality Review Organization (EQRO) reporting, and population health initiatives (20%)
• Support National Committee for Quality Assurance (NCQA) accreditation readiness and regulatory audits by maintaining accurate documentation and work plans (5%)
• Partner with care management, pharmacy, and provider networks to design and implement quality interventions that improve outcomes and reduce disparities (10%)
• Apply quality improvement methodologies (e.g., PDSA, Lean, Six Sigma) to evaluate workflows, streamline processes, and enhance operational efficiency (15%)
• Collect and analyze feedback (CAHPS, surveys, advisory groups) to inform strategies that improve access, coordination, and satisfaction (10%)
• Develop dashboards, reports, and presentations for leadership, committees, and external stakeholders, ensuring accuracy and timeliness (20%)
• Facilitate or support quality committees, workgroups, and cross-departmental projects focused on clinical and operational improvement (20%)

Requirements

Bachelor's Degree in Public Health, Nursing, or related field required. 4–6 years’ experience in health plan quality improvement, with direct experience in HEDIS and Stars required. CPHQ-Certified Professional Healthcare Quality - NAHQ - National Association for Healthcare Quality certification preferred.

Skills and Abilities

• Familiarity with Colorado Medicaid quality programs, HCPF requirements, and EQRO processes
• Demonstrated knowledge of NCQA accreditation standards, CMS requirements, and managed care operations
• Strong data analysis and reporting skills (Excel required; Tableau, SAS, or other tools preferred)
• Excellent communication and project management skills with ability to influence cross-functional teams
• Strong verbal and written skills

Benefits

At Denver Health, we offer a comprehensive benefits package including:

• Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
• 100% paid parental leave up to 6 weeks
• Immediate eligibility for retirement plans with employer contribution up to 9.5%
• Comprehensive medical, dental, vision plans in addition to employer-paid disability and life insurance
• Comprehensive well-being programs including on-site employee fitness center and nationally recognized RESTORE Center
• Free RTD EcoPass (public transportation)
• Childcare discount programs & exclusive perks on large brands, travel, and more
• Tuition reimbursement & assistance
• Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
• Professional clinical advancement program & shared governance
• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligibility