Quality Assurance & Improvement Specialist

Responsibilities

• Manage and conduct routine clinical case auditing processes to maintain high-quality clinical program operations
• Analyze workforce compliance to ensure Community Health Workers (CHWs) maintain strict fidelity to evidence-based best practices and the specific care standards outlined in our customer partnerships
• Audit case data to ensure clinical operations meet all customer quality requirements, including industry standards like NCQA-HEDIS and Medicare Stars
• Identify data inconsistencies, documentation gaps, and workflow errors in the care process, flagging them for review and root-cause analysis
• Define the clinical and operational requirements for quality measurement tools, working closely with the Data Analytics team to bring those tools to life
• Maintain, update, and own the data inputs for operational trackers and performance dashboards utilized in large-scale regional initiatives
• Compile raw operational data into clear, trending monthly reports for internal leadership and external partners
• Translate complex quality metrics into actionable insights and visual presentations
• Partner closely with multidisciplinary teams, including Operations, Data Analytics, User Experience, and Product, to share audit findings and brainstorm workflow solutions
• Support the planning and execution of continuous improvement projects aimed at increasing the quality of care, CHW team productivity, and overall system efficiency
• Assist in designing and facilitating staff training for navigation teams when new quality standards or improved care model processes are rolled out

Qualifications & Skills

• Bachelor's Degree is required; Master's Degree (MPH, MHA, etc.) is preferred
• 2 - 5 years of professional experience in healthcare quality assurance, data analysis, public health, or a related field
• Strong visual design and data presentation abilities
• High working proficiency in Excel and building reports
• Excellent written communication skills and the ability to operate independently
• A collaborative mindset with a track record of building positive working relationships across multiple teams
• Cultural humility: You are able to communicate effectively with people from various backgrounds and work respectfully across demographic, socioeconomic, language and, all other constituents that represent diverse cultures of communities