Ambulatory Quality Specialist

About the Job

General Summary of Position

Under the general supervision of the Director of Clinical Practice & Professional Development for MedStar Medical Group. The Ambulatory Quality Specialist supports the design execution and continuous improvement of quality initiatives across the ambulatory network. This role is responsible for extracting validating analyzing and translating quality performance data into actionable insights for practice teams and physician leadership. The Specialist supports gap closure efforts performance improvement initiatives regulatory readiness activities and value-based care reporting across ambulatory practices.

Primary Duties and Responsibilities

• Works directly with System Ambulatory Quality Compliance & Regulatory Performance Department for MedStar Health in order to contribute to the achievement of established goals and objectives and adheres to departmental policies procedures quality standards and safety standards.
• Extracts aggregates validates and analyzes quality data from electronic health records registries payer portals population health platforms and other reporting systems; monitors trends in quality measure performance (HEDIS MIPS payer-specific value-based contract and internal quality indicators) to identify performance gaps and potential root causes.
• Demonstrates behavior consistent with MedStar Health mission vision goals objectives and patient care philosophy.
• Develops maintains and distributes dashboards scorecards and summary reports that translate raw data into clear decision-ready insights for practice managers providers and physician leadership.
• Monitors annual and periodic updates to NCQA CMS and payer measure specifications as well as broader regulatory accreditation and payer program changes and assesses operational impact on workflows documentation and reporting.
• Partners with ambulatory practice sites to design and implement targeted improvement plans based on identified care gaps workflow breakdowns and performance opportunities; tracks intervention outcomes and recommends modifications based on results and ongoing performance monitoring.
• Assists with care gap closure initiatives patient outreach strategies and point-of-care workflow redesign in collaboration with clinical and operational staff.
• Supports ambulatory practices with quality reporting requirements tied to MIPS APMs QP programs payer incentives and other value-based arrangements including audit readiness documentation review and chart abstraction for quality measure validation and regulatory compliance.
• Serves as a liaison between the Quality department and ambulatory practice teams providers and administrative leadership to support alignment communication and execution of quality initiatives including participation in related meetings committees and workgroups.
• Prepares and presents quality performance summaries findings and recommendations to physician leadership practice leadership and quality committees.
• Provides education and just-in-time support to front-line staff regarding quality measure documentation workflow expectations and performance improvement opportunities.
• May be required to travel to ambulatory practices for on-site meetings

Minimal Qualifications

Education

• Associate's degree In Healthcare Administration, public health, health information management or a related field preferred or
• Bachelor's degree In Healthcare Administration, public health, health information management or a related field preferred
• Equivalent combination of education and relevant experience may be considered
• One year of relevant education may be substituted for one year of required work experience.

Experience

• 3-4 years Work experience in a healthcare clinical environment with proficiency working directly with electronic health records and quality or population health reporting tools required and
• 3-4 years Experience working in ambulatory clinical settings and experience with value-based and quality reporting programs preferred
• One year of relevant professional-level work experience may be substituted for one year of required education.

Licenses and Certifications

• Certified Medical Assistant (CMA)-AAMA Medical Assistant certification or comparable clinical or operational background acceptable preferred
• CPHQ - Certified Professional in Healthcare Quality preferred
• Six Sigma certification - SIXSIGMA Certification in a quality improvement methodology; such as Lean Six Sigma Green Belt or IHI Improvement Advisor preferred

Knowledge Skills and Abilities

• Demonstrated proficiency in extracting validating organizing and analyzing quality data from multiple sources.
• Eexcellent computer skills including expert use of Microsoft tools (not limited to Word Excel Teams etc)
• Ability to translate data into clear actionable recommendations for clinical and non-clinical audiences.
• Familiarity with data visualization tools such as Power BI or Tableau preferred.
• Understanding of ambulatory care workflows and the operational factors that affect quality measure performance.
• Effective written and verbal communication skills including the ability to present to physician leadership and committees.
• Strong organizational skills and the ability to manage multiple concurrent projects and deadlines.
• Collaborative and relationship-oriented approach to working across clinical and administrative teams.

This position has a hiring range of

USD $71,843.00 - USD $135,907.00 /Yr.