Quality Specialist 1 - St. Luke's Health Plan

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work. As a Quality Measure Specialist , you'll play a critical role in advancing quality performance, regulatory excellence, and member experience through the successful execution of HEDIS, NCQA, CMS Star Ratings , and other key quality initiatives. What you can Expect As part of our Quality team, you'll help ensure the accuracy, integrity, and impact of the data that drives healthcare quality improvement. Working across clinical, operational, and vendor partners, you'll support programs that improve member outcomes, strengthen regulatory compliance, and increase organizational performance. In this role, you will have the opportunity to: Drive quality measurement and improvement efforts by supporting HEDIS, NCQA, CMS Star Ratings, and other regulatory and performance initiatives. Review, abstract, and validate clinical data from electronic health records, medical records, and care management systems to ensure accurate and compliant quality reporting. Identify documentation gaps, data discrepancies, and improvement opportunities that impact quality performance, audit readiness, and measure outcomes. Partner with providers, vendors, and internal stakeholders to gather information, resolve data issues, and strengthen documentation and reporting practices. Coordinate quality projects, action plans, reporting activities, and operational deliverables that support organizational quality goals. Maintain audit-ready documentation, validation records, supporting evidence, and reporting logs for regulatory reviews, compliance audits, and delegated oversight activities. Monitor evolving quality measurement requirements and technical specifications, helping teams translate changes into operational improvements and sustainable processes. Contribute to initiatives that enhance measurement accuracy, data integrity, reporting reliability, and overall quality performance. Requirements Education: Bachelor’s degree or experience in lieu of degree At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work. As a Quality Measure Specialist , you'll play a critical role in advancing quality performance, regulatory excellence, and member experience through the successful execution of HEDIS, NCQA, CMS Star Ratings , and other key quality initiatives. What you can Expect As part of our Quality team, you'll help ensure the accuracy, integrity, and impact of the data that drives healthcare quality improvement. Working across clinical, operational, and vendor partners, you'll support programs that improve member outcomes, strengthen regulatory compliance, and increase organizational performance. In this role, you will have the opportunity to: Drive quality measurement and improvement efforts by supporting HEDIS, NCQA, CMS Star Ratings, and other regulatory and performance initiatives. Review, abstract, and validate clinical data from electronic health records, medical records, and care management systems to ensure accurate and compliant quality reporting. Identify documentation gaps, data discrepancies, and improvement opportunities that impact quality performance, audit readiness, and measure outcomes. Partner with providers, vendors, and internal stakeholders to gather information, resolve data issues, and strengthen documentation and reporting practices. Coordinate quality projects, action plans, reporting activities, and operational deliverables that support organizational quality goals. Maintain audit-ready documentation, validation records, supporting evidence, and reporting logs for regulatory reviews, compliance audits, and delegated oversight activities. Monitor evolving quality measurement requirements and technical specifications, helping teams translate changes into operational improvements and sustainable processes. Contribute to initiatives that enhance measurement accuracy, data integrity, reporting reliability, and overall quality performance. Requirements Education: Bachelor’s degree or experience in lieu of degree What's in it for you: At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals. St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law. *Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers. #J-18808-Ljbffr