Quality Submissions Specialist

Who You Are You’re a collaborative professional, driven by the potential to make a meaningful impact in healthcare. The challenges of healthcare don’t deter you—instead, you see them as opportunities to find innovative solutions that benefit the partners, people, and communities we serve. Honest Health’s commitment to purpose, innovation, communities, and kindness resonates with you, inspiring you to bring commitment, creativity, and compassion into your work. You’re ready to join a team focused on reimagining primary care for a healthier future that benefits all. Does this sound like you? Let’s connect. Who We Are At Honest Health, we believe in purpose and partnership to lead the transformation in primary care. Our team of healthcare experts and clinicians collaborates with a range of stakeholders—from health systems, physician organizations, and payers to providers, practices, and patients — to deliver innovative solutions that elevate care, control costs, and support long‑term health. Guided by our core values, we’re creating a value‑driven model that creates lasting benefits for everyone, now and into the future. For us, that’s just an Honest day’s work. Your Role As Quality Submissions Specialist, you will own the end‑to‑end technical and operational pathway for Medicare Shared Savings Program (MSSP) quality reporting under Centers for Medicare & Medicaid Services’ (CMS) Alternative Payment Model (APM) Performance Pathway and other quality program related submission as they arise. You will orchestrate multi‑EHR clinical data aggregation, patient matching/de‑duplication, measure validation, and submission file generation with our vendor partner (e.g., Medicare CQM JSON or eCQM/MIPS CQM QRDA III/FHIR), coordinating closely with internal partners and approved vendors/registries. Your work ensures data completeness and timely, accurate quarterly and annual submissions—foundational to our Accountable Care Organizations’ (ACOs) quality performance and shared‑savings outcomes. Primary Functions of the Quality Submissions Specialist Include: Aggregate and normalize clinical data across heterogeneous EHRs; define matching rules (NPI/TIN, CCN, demographics) and execute patient matching/de‑duplication for the eligible population. Validate measure logic and cohorts for the measure set (e.g., HbA1c poor control, depression screening + follow‑up plan, controlling high blood pressure, breast cancer screening) and maintain versioned specs/values as CMS updates occur. Monitor data completeness and case minimums; monitor vendor dashboards to surface gaps by practice/TIN/provider and drive remediation prior to file lock. Build, QA, and deliver files; manage schema validations, quality checks, and error handling. Coordinate with qualified registries and vendor for intake testing, sandbox validations, error resolution, and production submission; maintain service level agreements (SLAs) and post‑submission confirmation artifacts. Prepare regular performance and variance reports that tie measure readiness to action plans across markets; partner with Quality Program Managers and Market Ops to accelerate remediation. Document standard operating procedures (SOPs) and controls (source maps, lineage, metrics catalogs, QA checklists, audit trails) to ensure repeatable, auditable submissions year‑over‑year. Drive continuous improvement by analyzing submission defects and near‑misses; implement preventive controls and automation where feasible. Perform other related responsibilities as assigned. How You Qualify You reviewed the Who You Are section of this job posting and immediately felt the need to read on. This makes you a match for our innovative culture. You accept things change quickly in a startup environment and are willing to pivot quickly on priorities. Bachelor's degree in Business, Economics, Healthcare, or similar field. 5+ years in healthcare analytics or quality reporting (MSSP, MIPS/QPP, MA Stars, ACO REACH), including hands‑on eCQM/MIPS CQM/Medicare CQM submission experience. Strong data engineering skills; comfort with multi‑source ETL, data quality frameworks, and clinical data semantics (discrete fields vs. chart abstraction). Working knowledge of MSSP CQM requirements, data completeness standards (≥75%), and CMS file formats. Experience partnering with qualified registries/vendors for file intake/validation and coordinating production submissions. Demonstrated ability to operate in a deadline‑driven environment with impeccable documentation and stakeholder communication. Experience with Epic, Athena and Cerner or comparable EMRs (measure maintenance, cohort builder, campaign alignment) preferred. Exposure to QPP portal workflows and quarterly beneficiary list management preferred. The base pay range for this role is $76,600.00 - $88,900.00. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, and organizational needs. Base pay is just one piece of the total rewards program offered by Honest. Eligible roles also qualify for short‑term incentives and a comprehensive benefits package. Honest Health is committed to ensuring fairness, opportunity, strong teams, and full integration of team members into the organization. We take proactive steps to ensure all applicants are considered for employment based on merit, without regard to race, color, religion, sex, national origin, disability, Veteran status, or other legally‑protected characteristics. Honest Health is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email View email address on click.appcast.io for assistance. Reasonable accommodation will be determined on a case‑by‑case basis. #J-18808-Ljbffr Honest Health