The Quality Specialist supports the Wellness & Preventive Management (WPM) Program, with a focus on HEDIS measures, Annual Wellness Visits (AWVs), and care gap closure.
This role reviews medical records, abstracts clinical data, identifies missing quality measures, collaborates with providers and clinic staff, manages quality reports, monitors performance at the provider and group level, requests supporting documentation, and helps ensure accurate HEDIS data submission to health plans.
The position also supports quality improvement strategies and compliance with regulatory standards.
Requirements & Qualifications
- High school diploma required; bachelor's degree in a related field preferred.
- Certified Medical Assistant or Registered Medical Assistant preferred.
- Preferred: 1 year of experience in care coordination in an outpatient setting, HMO, MSO, or ACO.
- Foreign medical graduate preferred.
Benefits & Perks
- Health benefits
- Life insurance
- Long-term disability coverage
- Healthcare spending accounts
- Retirement plan
- Paid time off
- Pet insurance
- Tuition reimbursement
- Employee assistance program
- Wellness program
- On-site housing for select positions
Location
Hialeah, Florida, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 months ago