Quality Improvement Specialist
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Job Description
Quality Improvement Specialist advancing healthcare quality and population health outcomes at Gainwell Technologies. Applying QAPI, Lean, Six Sigma, and data analysis to improve Medicaid-related care.
Responsibilities:
- Apply quality improvement methodologies and change management principles, including IHI, PDSA, Lean, and Six Sigma
- Support Quality Assurance and Performance Improvement (QAPI) program activities
- Support the annual Quality Plan and Population Health interventions
- Collaborate across departments to align and support Population Health strategies
- Facilitate and monitor cross-functional quality improvement initiatives
- Maintain quality documentation, including policies, procedures, committee minutes, and program materials
- Support compliance activities related to External Quality Review Organization (EQRO) requirements
- Drive measurable outcomes, reduce variation, and improve member health outcomes
- Perform other duties as assigned
Requirements:
- 3–5 years of experience in healthcare quality improvement, preferably supporting Medicaid programs
- Bachelor's degree in a health-related, business, or similar discipline, or equivalent experience
- Experience applying IHI, PDSA, Lean, and Six Sigma methodologies and tools
- Experience facilitating root cause analysis, process mapping, and performance improvement projects (PIPs/QIPs)
- Experience analyzing data, identifying trends and disparities, and presenting findings to stakeholders
- Experience supporting Population Health initiatives and quality improvement efforts within a healthcare or managed care environment
- Knowledge of healthcare quality measures, HEDIS, quality withholds, and population health improvement concepts
- Proficiency with data analysis and data visualization techniques
- Ability to gather, analyze, validate, prioritize, and document business and operational requirements
- Knowledge of health equity and disparity-reduction initiatives
- Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Teams)
- SharePoint
- Power BI
- Strong verbal and written communication, critical thinking, risk identification, problem-solving, collaboration, conflict resolution, stakeholder management, time management, organization, adaptability, and ability to work effectively in a remote environment
Benefits:
- Work flexibility
- Learning and career development
- Flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- Leadership and technical development academies
- 10–15% travel for client meetings
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