A Clinical Quality Improvement Specialist is responsible for gathering, compiling, modeling, validating, and analyzing medical / clinical data needed by the organization in order to improve medical / clinical services or products that the organization delivers.
We are one of the top accountable care organizations (ACO) in the United States. Our company produces and manages proprietary applications, including multiple physician-facing mobile and web apps designed to enhance care coordination for our ACO participants. We are dedicated to driving innovation and excellence in value-based care.
The Opportunity:
We are seeking an ACO Quality Specialist to play a hands-on role in managing and improving quality programs across Medicare Shared Savings Program (MSSP), ACO REACH, and Commercial payer contracts. This role will support accurate quality reporting, gaps-in-care closure, CAHPS survey readiness, and health equity planning. You'll work directly with practices, providers, and consultants to ensure compliance while helping drive measurable improvements in patient care outcomes.
What You'll Do:
Manage day-to-day quality reporting for Medicare, ACO REACH, and Commercial programs. Track and close care gaps by distributing and monitoring Gaps-in-Care reports. Support data collection, validation, and analysis to identify opportunities for improvement. Train and educate providers and staff on quality program requirements, documentation, and workflow optimization. Support patient experience survey readiness (CAHPS) and promote strategies to improve response rates. Participate in payer audits and committee meetings, providing subject matter expertise. Collaborate with practices to improve outcomes in areas such as diabetes management, hypertension, and preventive screenings.
What We're Looking For:
Bachelor's degree in Nursing, Public Health, Healthcare Administration, or related field (Master's preferred). 3-5 years of healthcare quality or performance improvement experience, preferably in an ACO or value-based care setting. Strong knowledge of CMS ACO measures, HEDIS, STARS, and CAHPS. Experience in quality improvement methodologies (Lean, Six Sigma, PDSA, etc.). Excellent communication, provider engagement, and training skills. Strong data analysis skills; proficient in Excel, PowerPoint, and Word.
Preferred Qualifications:
Certified Professional in Healthcare Quality (CPHQ) or similar credential. Clinical background/licensure (RN, LPN) a plus. Familiarity with EHRs and healthcare analytics tools. Why Join PBACO? Be part of one of the nation's most successful ACOs. Contribute to programs that directly impact patient outcomes and health equity. Collaborative and mission-driven team environment. Competitive salary and comprehensive benefits package. Apply Today Join us in shaping the future of value-based care and improving healthcare quality for patients across South Florida and beyond.
