Job Description
Your Opportunity
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.
What you will do
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 every 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