Specialist, Care Quality jobs in United States
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Cano Health · 1 day ago

Specialist, Care Quality

Cano Health is committed to building the best primary care environment for patients and is seeking a Care Quality Specialist. This role is responsible for monitoring, analyzing, and improving healthcare quality performance across clinical facilities to support patient outcomes and regulatory compliance.

FitnessHealth CarePrimary and Urgent Care
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H1B Sponsor Likelynote

Responsibilities

Monitor quality metrics such as HEDIS, STAR measures, CMS and NCQA guidelines, and internal performance indicators
Analyze care gaps and collaborate with providers, care teams, and pharmacy to close adherence and preventive care gaps
Support quality reporting processes including dashboards, data validation, and performance summaries
Conduct audits and chart reviews to ensure documentation of accuracy and regulatory compliance
Inform center staff on quality measures and best practices to improve patient care outcomes
Assist with the development and implementation of quality improvement plans and intervention strategies
Communicate findings and trends to leadership and assist in action planning
Maintain up-to-date knowledge of healthcare quality standards and industry requirements, including HIPAA
Ability to multi-task efficiently and effectively
Communicate effectively by phone and in writing with providers, pharmacies, and patients
Adherence to all policies and procedures, including but not limited to standards for safety, attendance, punctuality and personal appearance
Participation in medical reviews, EMR updates and any additional training regarding medical documentation

Qualification

HEDISQuality improvementData reporting toolsCertified Professional CoderBilingual (English/Spanish)Analytical skillsCommunicationOrganizational skillsCritical thinking

Required

High School Diploma
Strong analytical and problem-solving skills
Proficient in data reporting tools, EMRs, and Microsoft Office
Ability to interpret NCQA Quality metrics and clinical documentation
Excellent communication and collaboration abilities
Strong organizational skills and attention to detail
Accountability and ownership
Critical thinking and process improvement mindset
Ability to work independently and as part of a team
Strong ethical standards and confidentiality awareness
Ability to multi-task efficiently and effectively
Communicate effectively by phone and in writing with providers, pharmacies, and patients
Adherence to all policies and procedures, including but not limited to standards for safety, attendance, punctuality and personal appearance
Participation in medical reviews, EMR updates and any additional training regarding medical documentation
Maintain up-to-date knowledge of healthcare quality standards and industry requirements, including HIPAA
Monitor quality metrics such as HEDIS, STAR measures, CMS and NCQA guidelines, and internal performance indicators
Analyze care gaps and collaborate with providers, care teams, and pharmacy to close adherence and preventive care gaps
Support quality reporting processes including dashboards, data validation, and performance summaries
Conduct audits and chart reviews to ensure documentation of accuracy and regulatory compliance
Inform center staff on quality measures and best practices to improve patient care outcomes
Assist with the development and implementation of quality improvement plans and intervention strategies
Communicate findings and trends to leadership and assist in action planning
This position works under usual office conditions
The associate is required to work at a personal computer as well as be on the phone for extended periods of time
Must be able to stand, sit, walk and occasionally climb
The incumbent must be able to work extended and flexible hours and weekends as needed
Physical demands include ability to lift up to 50 lbs
Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing
Flexibility to travel to clinical sites as needed

Preferred

Medical Assistant (MA)
Pharmacy Technician (CPhT)
Certified Professional Coder (CPC)
Certified Risk Adjustment Coder (CRC)
Nursing Student
Foreign Medical Graduate
Experience working with HEDIS, CAHPS and HOS, STARS programs
Prior role in healthcare quality, care management, or clinical support
Knowledge of value-based care models, managed care, or population health
eCW and insurance Portals experience preferred
Fluent in English; bilingual (English/Spanish) preferred

Company

Cano Health

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Cano Health is a rapidly growing operator of “Primary Care Plus” healthcare centers.

H1B Sponsorship

Cano Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (1)
2023 (1)
2022 (1)
2020 (1)

Funding

Current Stage
Public Company
Total Funding
$950M
Key Investors
Barry Sternlicht
2023-02-24Post Ipo Debt· $150M
2021-06-04Post Ipo Equity· $800M
2021-06-04IPO

Leadership Team

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Robert Camerlinck
Chief Operating Officer
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David Armstrong, Esq.
SVP, General Counsel, Chief Compliance Officer & Corporate Secretary
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Company data provided by crunchbase