LVN Quality Improvement Outreach Specialist

Job Description

Job Description

Overview

Opportunities for you!

• Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek

• Free Continuing Education and certification

• Tuition reimbursement, education programs and scholarships

• Vacation time starts building on Day 1, and builds with your seniority

• Free money toward retirement with a 403(b) and matching contributions

• Great food options with on-demand ordering

• Free parking and electric charging

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.

Responsibilities

The Quality Improvement (QI) Outreach Specialist supports Community Care Health’s Quality Improvement and Population Health Management (PHM) programs by performing LVN-level telephonic nursing assessment and executing member and provider outreach to support care gap closure, quality measure performance, and PHM initiatives. The role applies established clinical protocols to assess member needs, identify and document care gaps and clinical findings, and support appropriate escalation and follow-up within scope of practice. The position also supports HEDIS/HEQMS and preventive health and chronic condition initiatives, contributes to documentation and evidence collection for NCQA/accreditation readiness, and maintains accurate tracking and reporting of outreach activities under the direction of the Manager, Quality Improvement.

Work Schedule 8:00 AM – 4:30/5:00 PM (must remain consistent once established).

Ideal Candidate Traits:

• Strong verbal and written communication skills, including the ability to communicate professionally with members, providers, vendors, and internal stakeholders.
• Ability to conduct high-volume outreach while maintaining documentation quality, accuracy, professionalism, and confidentiality.
• Ability to identify barriers, unresolved issues, and member/provider concerns and escalate through established pathways.
• Basic knowledge of health plan operations, Quality Improvement, Population Health Management, HEDIS/care gap activities, or member/provider outreach.
• Ability to interpret basic clinical information (e.g., diagnoses, lab results, discharge summaries, medication lists, and care plans) to support identification of care gaps and appropriate follow-up actions within protocol guidelines.
• Ability to apply LVN-level nursing judgment within established clinical protocols to determine appropriate outreach actions, prioritize member needs, and identify when escalation to RN or provider is required.

"Day in the Life":

• Outreach & Care Gaps: Making individual outreach calls to close quality care gaps (e.g., annual wellness visits, annual PCP visits, colorectal and breast cancer screenings).
• Cross-Training & Tracking: Cross-training across the quality department, maintaining detailed trackers, and handling quality report data.

Qualifications

Education

• High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required.
• Completion of an accredited Vocational Nursing School program OR become licensed by equivalency required
• Associate’s Degree in Nursing, Health Administration, Public Health, Healthcare Quality, or related field preferred

Experience

• Minimum two (2) years of experience in member services, provider relations, outreach, call center operations, care coordination support, Quality Improvement, Population Health Management, health plan operations, or related healthcare functions preferred

• Experience supporting preventive care reminders, care gap outreach, HEDIS or quality improvement campaigns, provider/member education, or health-related outreach activities preferred

• Chart review experience (viewing doctor prescriptions and determining steps to help members secure appointments).
• Discharge planning and case management background is considered a strong plus.
  
• High proficiency in Microsoft Excel (creating and managing spreadsheets) and PowerPoint (developing presentations).
• High degree of organization, laser focus, ability to prioritize, and strong critical thinking.
• Experience maintaining detailed trackers, audit-ready documentation, workplans, and quality reports.
• Bilingual in Spanish is strongly preferred.
• Professional experience working in a healthcare environment (such as a hospital or a clinic) is a strong plus.

Licenses and Certifications

• LVN - Current and valid Licensed Vocational Nurse license to work within the state of California required