Quality Improvement Specialist (55399)
About The Position
Health Solutions is a premier wellness center focused on whole person care. With over 400 employees in Southern Colorado, you would be joining a mighty team of support and administrative staff, clinicians, physicians, nurses, and others in our efforts to improve the health and wellbeing of our community. We’re hiring a full-time Quality Improvement Specialist to join our Quality and Compliance group located at 41 Montebello Pueblo, CO 81001. Under the supervision of the Manager of Quality Assurance & Audit, the Quality Improvement Specialist leads agency-wide initiatives to enhance clinical and operational performance. This role applies evidence-based quality improvement methodologies to optimize workflows, ensure regulatory compliance, and support audit readiness and performance reporting. The specialist collaborates across departments to improve care delivery in both primary care and behavioral health settings, promoting integrated care best practices and fostering a culture of continuous improvement.
Requirements
- Bachelor's degree in public health, Healthcare Administration, Nursing, Social Work, or related field.
- Minimum of 2 years of experience in healthcare quality or performance improvement.
- Comprehensive knowledge of clinical workflows in primary care and behavioral health.
- Familiarity with state/federal reporting requirements.
- Proficiency in Microsoft Office, particularly Excel, and experience with EHR systems.
- Valid driver’s license and reliable transportation.
- Must already be authorized to work in the US; sponsorships not available.
Nice To Haves
- Master’s degree (MPH, MHA, MSW, MBA, or similar).
- Certification in CPHQ, Lean Six Sigma (Green or Black Belt), or equivalent certification.
- Experience in CCBHC or FQHC environments.
- Familiarity with NCQA standards Regional Accountable Entities (RAE), Behavioral Health Administration Service Organization (BHASO) and behavioral health metrics.
Responsibilities
- Drives agency-wide efforts to enhance both clinical and operational performance.
- Applies proven quality improvement methodologies—such as PDSA, Lean/Six Sigma, and IHI approaches—to optimize workflows, ensure regulatory compliance, support audit readiness, and contribute to performance reporting.
- Collaborates across departments to improve care delivery in primary care and behavioral health settings, while fostering a culture of continuous improvement throughout the organization.
- Lead quality improvement initiatives using frameworks such as PDSA, Lean/Six Sigma, or IHI methods to achieve measurable outcomes and process enhancements.
- Track and report on clinical quality measures, including HEDIS, CCBHC, eCQMs, and UDS, utilizing data analysis to drive informed decision-making.
- Collaborate with interdisciplinary teams to continuously improve care delivery and implement best practices in both primary care and behavioral health environments.
- Ensure ongoing compliance with RAE/BHASO and state regulations, including Behavioral Health Administration (BHA) and Health Care Policy and Financing (HCPF) requirements.
- Conduct root cause analyses (RCA) and develop corrective action plans in response to identified issues or process gaps.
- Validate electronic health record (EHR) data integrity and accuracy through systematic documentation audits and technical reviews.
- Support organizational accreditation and grant reporting efforts, such as PCMH, NCQA, and HRSA, by preparing and submitting required documentation.
- Deliver comprehensive education and training for staff on Quality Improvement tools, coding and documenting best practices, and evidence-based methodologies in accordance with regulatory and funding standards.
- Facilitate process improvement projects and drive continuous improvement by identifying opportunities for innovation and ensuring deliverables are met within scope and timeline.
- Design, implement, and monitor action plans based on audit findings and compliance reviews to improve service delivery, documentation, and billing practices.
- Prepare and distribute daily, weekly, and quarterly reports of audit and performance findings, offering actionable insights for leadership and teams.
- Undertake additional duties as assigned to further organizational goals and enhance the quality improvement program.
Benefits
- paid holidays
- generous PTO
- EAP
- tuition reimbursement
- retirement
- insurances
- FSA
- premier wellness program
- Medical, Dental, and Vision, with low deductibles
- Wellness benefits program available
- HS Funded: EAP, LifeLock, Ask Charlie, Life and AD&D, LTD
- Retirement 403(b) with employer match up to 6%
- Additional Insurance: FSA, Voluntary Life, Sun Life Voluntary benefits, and pet insurance
- Childcare
- Flexible work schedule
- Employee recognitions and celebrations
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
