Medical Assistant, Quality Improvement (HEDIS/HCC)

Job Description

Job Description

About Us
Healthy Horizons Clinics is a multi-location internal medicine and psychiatry practice serving patients in El Paso, Horizon City, and Denver. We’re committed to preventive, high-quality care, and our Quality Measures team plays a central role in helping patients stay on track with screenings, follow-ups, and chronic condition management.

About the Role
We’re looking for an experienced, bilingual Medical Assistant to join our Quality Measures team. In this role, you’ll work directly with patients, providers, and payers to close care gaps, support HEDIS and Star Ratings performance, and make sure our patients get the preventive care they need. This is a detail-driven, patient-facing role that rewards accuracy, organization, and follow-through.

Key Responsibilities

• Identify and close care gaps across assigned payers using payer reports, gap lists, and the EMR
• Conduct outreach calls to schedule preventive screenings, Annual Wellness Visits (AWVs), and follow-up appointments
• Complete hospital and ER discharge follow-ups within required timeframes
• Perform medication adherence reviews and outreach for diabetes, hypertension, and cholesterol medications
• Support patient experience survey outreach and education
• Review charts for HEDIS measure compliance and ensure documentation supports measure closure
• Assist with HCC documentation readiness by flagging chronic conditions that need to be addressed and recaptured annually
• Work assigned payer worklists, including Medicare Advantage, Medicaid, and Texas Health Steps
• Assist with payer attestations and supplemental data submissions
• Accurately log daily activity and submit end-of-day productivity reports
• Meet team productivity standards for each assigned task block

Required Qualifications

• Minimum of 1 year of experience as a Medical Assistant and with HEDIS gaps
• Bilingual in English and Spanish (verbal and written)
• Thorough understanding of care gaps and HEDIS quality measures , such as breast and colorectal cancer screening, diabetes care (A1c, eye exams, kidney health), blood pressure control, medication adherence, and transitions of care
• Solid working knowledge of HCC (Hierarchical Condition Category) risk adjustment and its role in documentation
• Strong understanding of Medicare, Medicare Advantage, and Medicaid plans, including how quality programs differ across them
• Excellent phone communication skills and comfort with high-volume patient outreach
• Strong attention to detail and the ability to manage multiple worklists and deadlines
• Proficiency with Microsoft Excel and general computer skills

Preferred Qualifications

• Experience with eClinicalWorks (eCW)
• Familiarity with payer portals such as WellMed, Humana, Devoted, Wellcare, Alignment, or Molina
• Experience with Star Ratings, AWVs, or care management programs (CCM/APCM/BHI)
• Medical Assistant certification (CMA, RMA, CCMA, or equivalent)