Population Health & Quality Engagement Specialist

About the Role

A Population Health & Quality Engagement Specialist (PHQES) contributes to AHF by blending the mission with proactive engagement of attributed and high-risk populations to ensure timely access to care, closure or mitigation of quality care gaps, and fulfillment of payer contractual obligations. This role operationalizes population health strategies through structured outreach, documentation, and performance reporting, directly supporting quality outcomes, retention, compliance, and value-based revenue care coordination.

The PHQES works in conjunction with the Payor Relations Quality Improvement & Contracting teams to ensure that all attributed patients have access to primary care services, addressing urgent healthcare needs, overdue screenings, or unmanaged chronic conditions, as well as reducing avoidable ER visits and hospitalizations. The PHQES serves as a critical link between attribution, access, quality performance, and reporting, ensuring that engagement efforts are measurable, auditable, and aligned with organizational and payer expectations.

The ideal PHQES maintains concentrated customer focus and cultural competency, enhancing AHF’s reputation by improving access to care and promoting improved health outcomes.

Responsibilities

• Perform compassionate, ethical, and professional telephonic outreach to 100% of newly attributed patients within the designated timeframe.
• Facilitate appointment scheduling for ≥30% of contacted patients.
• Ensure 100% documentation of outreach attempts and patient responses, including appropriate documentation for unresponsive or declining members to demonstrate due diligence and reduce organizational liability.
• Support closure or mitigation of quality care gaps related to HEDIS, STARs, preventive care, and chronic condition management.
• Produce, monitor, and analyze outcome reports related to engagement timelines for newly attributed members, outreach completion rates, contact success rates, appointment scheduling, and visit completion.
• Prepare regular performance summaries for leadership, quality, and population health teams, identifying trends, gaps, and opportunities for improvement.
• Escalate risks related to access, quality, or contractual compliance.
• Support closing quality care gaps via supplemental data submission.

Requirements

• Previous experience in a customer support role required.
• Managed Care Experience preferred.
• Bilingual (Spanish) preferred.
• Familiarity with EHR systems and clinical practices.
• Excellent written and verbal communication skills.
• Ability to multi-task, set priorities, and manage time effectively.
• Detail-oriented with the ability to manage multiple competing priorities simultaneously.

About AHF

Founded in 1987, AIDS Healthcare Foundation (AHF) is the largest specialized provider of HIV/AIDS medical care in the world. Our mission is to provide cutting-edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research, and other activities, AHF provides access to the latest HIV treatments for all who need them.

At AHF, we are nimble and adaptable in a dynamic environment to assist in providing the best experience for our clients and workplace for our employees. AHF has a collaborative organizational structure where staff are accountable to multiple leaders.