Quality Assurance & Improvement Specialist

Activate Care•Boston, MA

About The Position

At Activate Care, we’re on a mission to improve health equity and drive improved health outcomes across the country. Our Community Care Record platform enables healthcare and community organizations to coordinate care for populations challenged with health-related social needs. Path Assist is our tech-enabled community health worker program for HRSN utilizing an evidence-based, structured intervention. Our goal is simple: increase health confidence, improve self-efficacy, and reduce inappropriate healthcare spend. Role Overview: The Quality Assurance & Improvement Specialist is a hands-on, highly collaborative role designed for a professional looking to grow their career in healthcare quality and clinical operations. This individual will be responsible for executing quality assurance audits for our Path Assist program while identifying areas for process improvement. Operating at the intersection of clinical care and data, you will help track workforce adherence, manage regional data reporting, and collaborate across departments to fix operational bottlenecks.

Requirements

Bachelor’s Degree is required; Master’s Degree (MPH, MHA, etc.) is preferred
2 - 5 years of professional experience in healthcare quality assurance, data analysis, public health, or a related field.
Strong visual design and data presentation abilities.
High working proficiency in Excel and building reports.
Excellent written communication skills and the ability to operate independently.
A collaborative mindset with a track record of building positive working relationships across multiple teams.
Cultural humility: You are able to communicate effectively with people from various backgrounds and work respectfully across demographic, socioeconomic, language and, all other constituents that represent diverse cultures of communities.

Nice To Haves

Familiarity with healthcare populations (Medicaid, MCOs) and a strong understanding of community-based care interventions and social determinants of health (SDOH).

Responsibilities

Manage and conduct routine clinical case auditing processes to maintain high-quality clinical program operations.
Analyze workforce compliance to ensure Community Health Workers (CHWs) maintain strict fidelity to evidence-based best practices and the specific care standards outlined in our customer partnerships.
Audit case data to ensure clinical operations meet all customer quality requirements, including industry standards like NCQA-HEDIS and Medicare Stars.
Identify data inconsistencies, documentation gaps, and workflow errors in the care process, flagging them for review and root-cause analysis.
Define the clinical and operational requirements for quality measurement tools, working closely with the Data Analytics team to bring those tools to life.
Maintain, update, and own the data inputs for operational trackers and performance dashboards utilized in large-scale regional initiatives.
Compile raw operational data into clear, trending monthly reports for internal leadership and external partners.
Translate complex quality metrics into actionable insights and visual presentations.
Partner closely with multidisciplinary teams, including Operations, Data Analytics, User Experience, and Product, to share audit findings and brainstorm workflow solutions.
Support the planning and execution of continuous improvement projects aimed at increasing the quality of care, CHW team productivity, and overall system efficiency.
Assist in designing and facilitating staff training for navigation teams when new quality standards or improved care model processes are rolled out.
Other duties as assigned.