Quality Performance Specialist

Quality Performance Specialist

The Quality Performance Specialist is responsible for supporting quality performance improvement across a network of practices participating in value-based care contracts, including MSSP, ACO REACH, Medicare Advantage, Commercial, and Medicaid programs. This role serves as a key partner to practices, providing education, performance insights, and strategic guidance to improve quality outcomes, documentation accuracy, and care delivery workflows. The Specialist works closely with internal teams and external stakeholders to ensure alignment between payer requirements, practice operations, and patient outreach efforts.

Practice Performance & Improvement Planning

• Identify high-impact opportunities for improvement and develop actionable, practice-specific performance plans
• Lead quarterly quality performance reviews for assigned practices, with monthly engagements for prioritized or underperforming practices
• Implement targeted interventions for practices with gaps in quality performance or operational barriers
• Coordinate closely with Practice Transformation and other practice-facing teams to ensure aligned communication and strategy

Education & Workflow Optimization

• Provide ongoing education to providers and practice staff on quality measures, value-based care requirements, and performance expectations
• Support CPT II coding education and adoption, particularly for private payer contracts
• Assist in the development and dissemination of educational materials, tip sheets, and training resources
• Guide practices in optimizing workflows related to preventive care, chronic disease management, and patient engagement
• Coach practices on gap closure strategies and integration of quality measures into daily operations

Data Integrity & Quality Reporting

• Troubleshoot discrepancies between EHR data, internal reports, and payer-reported performance
• Identify and escalate EHR data integrity or feed issues to analytics and IT teams
• Conduct focused chart reviews to validate documentation accuracy and identify opportunities for improvement
• Support the collection and validation of quality data needed to close care gaps across all lines of business
• Assist with quality reporting and submission processes to ensure completeness, accuracy, and optimal performance

Payer Alignment & Cross-functional Collaboration

• Work across all lines of business to ensure consistent understanding and execution of quality strategies
• Participate in payer-hosted quality meetings and incorporate updates into practice education and internal workflows
• Collaborate with internal teams to align patient outreach strategies with practice needs and priorities

What Will Make You Successful Here

• Minimum of 3 years of experience in healthcare quality, population health, value-based care, or ambulatory practice operations
• Experience working with quality programs such as MSSP, ACO REACH, Medicare Advantage (HEDIS/Stars), or Commercial/Medicaid quality initiatives
• Experience supporting or engaging directly with primary care practices or provider groups
• Familiarity with EHR systems, clinical documentation workflows, and quality reporting processes
• Strong understanding of quality measures, gap closure strategies, and value-based care principles
• Ability to interpret data and translate insights into actionable recommendations for practices
• Excellent communication and presentation skills, with the ability to educate providers and clinical staff effectively
• Strong problem-solving skills with the ability to troubleshoot data and workflow issues
• Ability to manage multiple priorities and work independently in a remote environment
• Collaborative mindset with strong cross-functional partnership skills

Preferred Qualifications

• Experience with CPT II coding and documentation optimization strategies
• Knowledge of eCQMs, digital quality measures, and electronic reporting requirements
• Experience conducting chart reviews or supporting quality audits
• Background in primary care clinical operations or care delivery workflows
• Advanced proficiency in Excel or experience with healthcare analytics and reporting tools
• Certification in healthcare quality (e.g., CPHQ) or a related field

Perks/Benefits

• Competitive base compensation
• Annual bonus potential
• Health benefits effective on start date
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
• 5 sick days and unlimited (or generous) paid "Vytal Time" after your first 90 days
• Company paid STD/LTD
• Technology setup
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization

Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information. We will also never ask for you to purchase anything; nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com