Quality Improvement Nurse

Duly Health and Care • Downers Grove, IL

3h • Onsite

About The Position

Duly Health and Care is seeking a driven Quality Improvement Nurse to join their team. This role is responsible for driving measurable improvement in clinical quality metrics, Stars/HEDIS performance, and care gap closure, directly impacting quality revenue and value-based contract outcomes. The Quality Improvement Nurse will collaborate with providers, clinic staff, and operational leadership to identify care gaps, improve medication adherence, and implement performance-driven quality initiatives. This position requires a high level of accountability for achieving quality targets, optimizing payer incentive performance, and demonstrating measurable outcomes. The ideal candidate will independently evaluate quality performance data, interpret payer incentive structures, identify high-value improvement opportunities, and prioritize initiatives for maximum clinical and financial performance. Strong analytical skills and advanced proficiency in Excel and data analysis are essential for trend analysis, performance forecasting, incentive impact assessment, and initiative monitoring. The role also involves independently developing, executing, and adjusting targeted action plans while participating in shared decision-making with providers and leadership.

Requirements

• Bachelor’s in nursing, Preferred
• Active Registered Nurse (RN) license in good standing.
• Minimum of 2+ years of experience as a Registered Nurse in primary care, care management, population health, quality improvement, or value-based care environment.
• Experience supporting HEDIS, Stars, or other clinical quality measures preferred.
• Experience interpreting payer incentive programs or performance methodologies preferred.
• Strong analytical skills with advanced proficiency in Microsoft Excel required.
• Experience managing multiple concurrent initiatives in a fast-paced, performance-driven environment.
• Demonstrated proactive, solutions-oriented, and accountable work mentality.
• Advanced analytical and data interpretation skills.
• Ability to interpret payer incentive structures and quality measure weighting.
• Strong independent thinking and decision-making capability.
• Ability to develop and execute targeted performance improvement plans.
• Strong provider-facing communication and training skills.
• Performance-driven mindset with accountability for measurable outcomes.
• Adaptability in a rapidly changing environment.
• Strong collaboration skills with providers and leadership teams.
• Detail-oriented with strong organizational skills.
• Self-starter, resourceful, resilient, and action-oriented with proactive problem-solving mindset.

Nice To Haves

• Experience supporting HEDIS, Stars, or other clinical quality measures
• Experience interpreting payer incentive programs or performance methodologies

Responsibilities

• Analyze payer, clinical, and operational data to identify quality gaps, performance trends, and high-impact patient populations based on clinical risk and payer incentive weighting.
• Interpret payer contracts, quality incentive methodologies, and measure specifications to independently design targeted plans of action and performance interventions.
• Utilize advanced Excel skills to perform trend analysis, forecasting, incentive impact modeling, and performance monitoring.
• Independently develop, implement, and adjust action plans to improve quality metrics, Stars/HEDIS performance, medication adherence, and care gap closure.
• Conduct proactive patient outreach to support care gap closure and medication adherence; accountable for closing the loop and documenting measurable outcomes.
• Educate patients on the clinical significance of preventive care, chronic disease monitoring, and the importance of closing HEDIS/Stars gaps to improve long-term outcomes.
• Assess clinical, behavioral, and social barriers to care gap closure; coordinate multidisciplinary solutions and ensure documented resolution of gaps.
• Identify systemic workflow barriers and lead implementation, evaluation, and refinement of clinic workflows to improve quality performance and reduce recurring gaps.
• Provide measure-specific education and training to providers, clinic staff, and office teams on documentation requirements, quality metrics, and incentive impact.
• Develop and deliver standardized training materials, including handouts and slide decks, to support provider engagement and performance improvement.
• Participate in shared decision-making with providers and leadership to align performance improvement strategies with organizational goals.
• Support multiple quality initiatives simultaneously, including medication adherence, care gap closure, and broader quality measure improvement.
• Maintain detailed and accurate documentation of outreach, interventions, performance impact, and outcomes.
• Act as a subject matter resource regarding quality measures, payer incentive structures, adherence strategies, and workflow best practices.
• Support the development and refinement of quality improvement procedures, policies, protocols, and reporting tools.
• Adapt quickly to frequent workflow updates, operational changes, and evolving quality program requirements.
• Support special projects and additional quality improvement initiatives as assigned.

Benefits

• Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance.
• Employer provided life and disability insurance.
• $5,250 Tuition Reimbursement per year.
• Immediate 401(k) match.
• 40 hours paid volunteer time off.
• Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level