Quality Specialist

Quality Specialist

As a Quality Specialist, you will be responsible for performing outbound patient calls regarding our clinical programs, medication adherence, and closing gaps in care for value-based contracted patients with clinical quality needs. The role will partner closely with our quality, population health, and pharmacy teams to effectively deliver wrap-around care for our patients. The ideal candidate will have the ability to work in a fast-paced environment while using excellent communication skills to serve our patients. They must be proactive with a strong personal initiative, as well as highly organized and detail oriented.

How You Will Get Things Done:

• Call patients to ensure they refill their chronic disease medications on time for diabetes, blood pressure, and cholesterol
• Serve as liaison between patient, clinic, and pharmacy to minimize time missed between refills
• Interpret patient medical history (medication list, office visit notes, etc.) and understand and properly communicate provider's plan to patient
• Navigate between different Electronic Medical Record (EMR) platforms to review patient medical information
• Accurately and comprehensively document patient care activities in all applicable electronic records
• Perform appropriate medication reconciliation by comparing how your patient is taking medication versus what is written in medical record and/or filled at the pharmacy
• Request medication refills per clinic policy and protocol
• Adequately assist patients with difficulties accessing medication due to cost or other barriers
• Identify patients who need referrals to clinical pharmacist, retail pharmacy med sync program, retail pharmacy medication pack program, care management, clinician, and/or Village at Home
• Timely follow up and persistent outreach to patients, providers, and pharmacies to ensure medications are picked up and taken as directed
• Connect with patients before and after their primary care visit, if necessary, to help coordinate the completion of their quality health maintenance
• Schedule appointments and testing and/or order screenings per standardized protocols
• Maintain current knowledge of quality measure requirements
• Scheduling patient appointments as needed for refills/barriers
• Assisting other quality departments as needed per quarter

How You Will Build Trust:

• Demonstrate kindness and compassion in all patient interactions
• Actively participate as a member of the health care team to promote positive health outcomes for our patients and support our healthcare partners
• Participate in team building exercises/tools
• Coordinate with pharmacy staff, primary care office staff and/or providers to ensure appropriate referrals, orders, and tests are in place for the patient

How You Will Innovate:

• Contribute to increasing overall quality ratings for clinic by ensuring patients refill and take their medication on time and as directed
• Identify opportunities for continuous process improvement

EXPERIENCE TO DRIVE CHANGE

• High school diploma or GED equivalent required
• Certified Medical Assistant, Certified Pharmacy Technician, or equivalent experience in a healthcare setting required
• Intermediate to advanced level keyboarding skills (at least 35 WPM, touch typing, formatting documents) required
• Work from home environment:
• Secure workspace at home, including desk and chair, with minimum background noise required
• Candidate supplied home internet access required
• Minimum internet download speed of 100mbps and upload speed of 10mbps required
• Internet to be hard-wired with an ethernet cord required. Wi-Fi connection cannot be used.
• 1+ years of experience in a healthcare setting preferred
• Prior experience using an Electronic Health Record (EHR) preferred
• Previous call center or telephonic experience preferred
• Experience with Medicare Advantage plans, insurance, and medication adherence preferred
• Bilingual English/Spanish preferred

Total Rewards at VillageMD

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD's benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Equal Opportunity Employer

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Safety Disclaimer

Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, or file a complaint at