Quality Reporting Specialist, Remote

The Quality Reporting Specialist ensures practice and ACO success in Medicare Advantage and commercial contracts, focusing on HEDIS quality measures. This role requires expertise in HEDIS, chart review (EHRs and paper) for quality gap closure, strong attention to detail, and excellent communication skills. The specialist will retrieve and submit documentation to health plans and consult with field teams on reporting strategy. This is a remote position within the U.S.

Must Have

• Apply knowledge of HEDIS quality measures for incentivized contracts.
• Access practices in-person or remotely to retrieve documentation for quality gaps.
• Submit documentation to health plans using optimal methods.
• Coordinate Electronic Health Record (EHR) system access set-up & login management.
• Consult with market field team members on quality reporting strategy.
• 1+ years experience in quality reporting in healthcare or health plan setting.
• Experience working within at least one major Electronic Health Record system.
• Comfortable exporting, formatting, and reporting data (Excel or Google Sheets).
• Able to work independently and prioritize deadlines.
• Track and communicate progress; escalate barriers to performance.
• Strong written and verbal communication skills.
• Strong attention to detail.

Good to Have

• Bachelor’s degree or equivalent work experience.
• G-Suite Proficiency.
• Experience working with the Medicare Advantage STARS program and HEDIS measures.

Perks & Benefits

• Flexible work schedules and remote work options.
• Health, dental, and vision insurance (up to 80% paid for employees, dependents, domestic partners).
• Robust time-off plan (21 days of PTO in first year).
• Two paid volunteer days and 11 paid holidays.
• 12 weeks paid parental leave for all new parents.
• Six weeks paid sabbatical after six years of service.
• Educational Assistant Program and Clinical Employee Reimbursement Program.
• 401(k) with up to 4% match.
• Stock options.

Primary Duties:

• Apply knowledge of HEDIS quality measures for addressing incentivized, contract measures across multiple Medicare Advantage and commercial health plans to ensure practice and ACO receive credit for services received by patient
• Access practices in-person or remotely to retrieve documentation to address quality gaps and / or work closely with field team to assist guiding practices through gap closures
• Submit documentation to health plans and employ optimal method in each practice (i.e., upload to payor portal, secure email, etc)
• Coordinates Electronic Health Record (EHR) system access set-up & login management
• Consult with market field team members on quality reporting strategy - providing relevant market updates and chart review feedback for assigned practices

Minimum Qualifications:

• 1+ years experience in quality reporting in healthcare or health plan setting
• Experience working within at least one (1) major Electronic Health Record system (athenaHealth, eCW, etc)
• Comfortable exporting data, formatting and reporting out results (Excel or Google Sheets experience)
• Able to work independently and prioritize deadlines
• Track and communicate progress; escalate barriers to performance
• Strong written and verbal communication skills
• Strong attention to detail

Preferred KSAs:

• Bachelor’s degree is preferred or equivalent work experience
• G-Suite Proficiency
• Experience working with the Medicare Advantage STARS program and HEDIS measures

Physical Requirements:

• Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.

Who We Are:

Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

What Does This Mean for You?

At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners

Robust time-off plan (21 days of PTO in your first year)

Two paid volunteer days and 11 paid holidays

12 weeks paid parental leave for all new parents

Six weeks paid sabbatical after six years of service

Educational Assistant Program and Clinical Employee Reimbursement Program

401(k) with up to 4% match

Stock options

And much more!

At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

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We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us.