Clinical Quality Specialist

Altais

Base: $80,000 - $100,000pyear; bonus/equity: not s...
3+ years managed care quality experience
Hedis and cms star ratings knowledge
Medical record review and gap closure
The role focuses on supporting quality improvement efforts by closing care gaps through HEDIS, CMS Star Ratings, and patient experience measures

Job Summary

  • The role focuses on supporting quality improvement efforts by closing care gaps through HEDIS, CMS Star Ratings, and patient experience measures.
  • Candidates will work directly with health plans and provider practices to conduct medical record reviews and deliver educational materials.
  • The company offers a competitive salary range of $80,000-$100,000 along with excellent medical, vision, dental coverage, and a 401k match.

Matching Summary

The role focuses on supporting quality improvement efforts by closing care gaps through HEDIS, CMS Star Ratings, and patient experience measures.

Salary

Base: $80,000 - $100,000/year; Bonus/Equity: Not specified; Benefits: Excellent medical, vision, dental, 401k match, flexible time off

Skills & Requirements

Must-have

  • 3+ years managed care quality experience
  • HEDIS and CMS Star Ratings knowledge
  • Medical record review and gap closure
  • Provider scorecard and report preparation
  • Member outreach campaign execution

Nice-to-have

  • Collaborative team culture
  • Adaptability to changing healthcare needs
  • Experience with CAHPS and P4P programs
  • Strong communication with stakeholders
  • Commitment to physician support mission

Key Requirements

  • Minimum 3 years relevant experience in managed care or clinical program management
  • Working knowledge of NCQA Quality Improvement standards
  • Familiarity with Managed Care Accountability Set (MCAS)

Work Rights

Not specified

Tailored Resume

Cover Letter