Quality Specialist

As Mount Sinai grows, so does our legacy in high-quality health care.Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.Culture of Caring: The Sinai WayOur hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.Department:CC019053 Population Health Clinical OpsJob Description Summary:The Quality Specialist supports the Wellness & Preventive Management (WPM) Program, focusing on HEDIS measures, Annual Wellness Visits (AWVs), and care gap closure. This role is responsible for reviewing medical records, abstracting clinical data, identifying missing quality measures, and collaborating with providers and clinic staff to improve performance and patient outcomes.Key responsibilities include managing quality reports, monitoring provider-level performance, requesting documentation from external sources, and ensuring accurate submission of HEDIS data to health plans. The Quality Specialist partners closely with leadership to execute quality improvement strategies and drive compliance with regulatory standards.Position ResponsibilitiesResponsible for supporting the Wellness & Preventative Management Program (WPM): HEDIS, Annual Wellness Visits, Appointments, and other Care Coordination tasks.Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting, e.g. results of laboratory tests, verification of hypertension and the most recent blood pressure reading.Collect medical record data and identify needed improvements that impact HEDIS measures.Review noncompliant reports and flags patient’s charts with the missing measures.Request quality data documentation from outside resources.Works closely with leadership to execute quality strategies.Manage the reports and monitors performance at group and providers level.Engages PCP and clinic staff in developing strategies to close quality gaps.Upload HEDIS data to medical records and send it to the health plan.Performs all other related duties as assignedQualificationsLicense/Registration/CertificationPreferred Certified Medical Assistant or Registered Medical Assistant.EducationRequired: High School Diploma. Preferred: Bachelor of Sciences degree or in other related field, foreign medical graduateExperiencePreferred: One year of experience in Care Coordination in outpatient setting or HMO, MSO or ACO.Benefits:We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:Health benefitsLife insuranceLong-term disability coverageHealthcare spending accountsRetirement planPaid time offPet InsuranceTuition reimbursementEmployee assistance programWellness programOn-site housing for select positions and more!Degree Requirements:Certification: #J-18808-Ljbffr