Health Equity Quality Specialist

Mass General Brigham•Somerville, MA

1d•Remote

About The Position

Mass General Brigham Health Plan is a dynamic part of the healthcare industry, operating within one of the world's leading integrated healthcare systems. The organization is committed to transforming healthcare by providing innovative solutions that expand access to seamless and affordable care and coverage, with a strong focus on creating an exceptional member experience. The Health Equity Specialist plays a crucial role in supporting Mass General Brigham Health Plan’s quality and accreditation strategy, specifically focusing on NCQA Health Equity requirements. This position acts as a subject matter expert for NCQA Health Equity Accreditation standards, collaborating across the organization to plan, coordinate, and execute health equity initiatives that align with accreditation, regulatory, and quality improvement goals. The Specialist is responsible for leading and managing cross-functional projects related to health equity performance, documentation, and readiness, ensuring timely completion and adherence to NCQA standards. A key aspect of the role involves maintaining continuous accreditation readiness by coordinating evidence collection, tracking requirements, monitoring project progress, and supporting internal and external reviews. The ideal candidate will have prior experience in a health plan quality department, strong familiarity with NCQA health equity standards, and proven project management skills to drive complex initiatives involving multiple stakeholders. The role requires a deep understanding of health equity requirements from both regulatory and accreditation perspectives, providing expert guidance to business partners while managing health equity initiatives within the quality team.

Requirements

Bachelor's Degree
At least 2-3 years of experience in a health plan quality department, specializing in health equity
Strong understanding of document management systems (DMS), such as SharePoint, OpenText, or Documentum, to manage digital files, track revisions, and maintain version control.
Familiarity with cloud storage systems and collaboration tools like Google Drive, Dropbox, and Microsoft OneDrive.
Experience with electronic records management (ERM) and data retention policies.
Demonstrates awareness of importance of security, scalability, reliability and feasibility in solutions.
Seeks out information to better understand impacts of design and implementation of systems.
Evaluates service areas to identify opportunities for automation.
Ability to draft, revise, and implement company policies and standard operating procedures.
Knowledge of compliance standards, including industry-specific regulations (e.g., healthcare HIPAA regulations, financial regulations, state and federal rules).
Strong organizational skills to ensure policies and documents are properly filed, categorized, and easy to access.
Ability to spot discrepancies or issues in documents and ensure compliance with required guidelines.
Breaks complex topics into meaningful chunks of information.
Seeks out multiple sources to gather information.
Understanding of legal and regulatory requirements for document retention and management, including data privacy and security laws.
Knowledge of audit procedures and the ability to prepare documentation for audits.
Excellent written and verbal communication skills for drafting policies and procedures, as well as providing guidance to employees about document handling and compliance.
Ability to train staff on document management practices and policy changes.
Experience using document management software and workflow tools to streamline document processes and improve efficiency.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and other productivity tools.
Familiarity with document control software for versioning, workflow management, and access permissions.
Ability to manage multiple tasks or projects simultaneously, adhering to deadlines and ensuring that policies and documents are up to date.
Strong critical thinking skills for analyzing policies and procedures to ensure they align with organizational goals and legal requirements.
Excellent interpersonal skills, including the ability to influence others at all levels of an organization.

Nice To Haves

Master's Degree
At least 5 years in health plan quality in a managed care organization
At least 3 years in health equity-facing role from a payor perspective
Experience in healthcare quality, health equity initiatives, population health, or related program coordination
Familiarity with QI methodologies and regulatory standards
Experience working with diverse communities or in community health, managed care, or hospital quality departments
Certification in healthcare quality or equity (e.g., CPHQ, CPHE, Lean Six Sigma)
Experience with SDOH screening tools, community partnerships, or health literacy initiatives
Experience with project management software, such as Trello or Microsoft Project

Responsibilities

Drafting, reviewing, and revising internal policies and procedures to ensure alignment with industry standards, legal requirements, and best practices.
Identify disparities in clinical outcomes, access, and patient experience through data analysis and quality metrics.
Develop, implement, and monitor health equity action plans tied to organizational quality goals and regulatory requirements.
Support quality improvement (QI) projects using methodologies such as PDSA, Lean, or Six Sigma.
Collaborate with care teams to integrate equity principles into workflows, care pathways, and population health strategies.
Comprehensive health equity program management, ensuring compliance to regulatory requirements to ensure constant state of audit and accreditation readiness.
Collect, stratify, and analyze data by race, ethnicity, language, gender identity, sexual orientation, socioeconomic status, and other demographic factors.
Produce dashboards, reports, and presentations to communicate disparities and improvement opportunities.
Ensure accurate documentation and compliance with national, state, and accreditingbody standards (e.g., CMS, NCQA, Joint Commission).
Facility development and ensure delivery of state, federal, and other reporting requests.
Ensuring that all policies and documents meet legal, regulatory, and industry-specific compliance standards.
Preparing for and supporting internal and external audits by providing the necessary documentation and ensuring that policies and records are up to date.
Identifying risks associated with inadequate documentation or non-compliance with policies and working to mitigate those risks.
Maintaining proper security protocols for sensitive documents to prevent data breaches or unauthorized access.
Review and recommend modifications to policies, procedures, and programs to enhance equity and inclusion.
Partner with community organizations, patient advocates, and internal teams to support outreach and engagement of marginalized populations.
Ensure development and execution of foundational program documents, complying with regulatory and accreditation standards.
Complete ongoing program oversight to ensure implementation of program and initiatives across the business lines.
Manage appropriate committees including compiling agendas, meeting minutes, and presentations.
Other duties as assigned.