Quality Improvement Data Coordinator-Medicare Advantage

As outlined below, provide quality improvement focused work for all delegated entities and support for ACO quality reporting for all contracted ACOs.

WHAT YOU’LL BE DOING

• Work in a partially remote environment, collaborating with team members virtually each day.
• Serve as a Subject Matter Expert (SME) on quality improvement measures, customer needs, and payer‑specific quality initiatives across commercial and government programs.
• Travel to provider offices to support quality efforts, including completing on‑site eye exams (training provided), scanning records, and coordinating medical record management.
• Conduct proactive patient outreach to identify and close quality gaps—educating patients, scheduling screenings, supporting treatment plan adherence, and improving outcomes.
• Collect and abstract quality data using EMRs, claims information, and provider engagement.
• Use multiple platforms daily, including EMR systems, payer portals, vendor tools, GuideHealth applications, and Microsoft 365 (Excel, Word, PowerPoint, Teams).
• Work with various health data sources, including patient lists, gap lists, and medical records.
• Apply all available quality resources—NCQA/HEDIS® specifications, coding materials, and Guides—to ensure accuracy and completeness.
• Prioritize tasks to meet strict reporting timelines and quality program requirements.
• Communicate performance trends, barriers, and improvement strategies to internal teams and external partners.
• Follow established QI workflows, processes, and best practices.
• Collaborate daily with customers, payers, and internal teams.
• Participate in payer and departmental trainings, webinars, and support calls.
• Represent GuideHealth professionally and build positive working relationships with providers and staff.