Specialist, Care Quality

Cano Health•Miami, FL

12d

About The Position

It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The Care Quality Specialist is responsible for monitoring, analyzing, and improving healthcare quality performance across clinical facilities. This role supports organizational goals related to patient outcomes, regulatory compliance, and quality improvement initiatives by tracking key performance indicators, identifying gaps in care, and collaborating with multidisciplinary teams to implement corrective actions.

Requirements

High School Diploma required.
Fluent in English; bilingual (English/Spanish) preferred.
Strong analytical and problem-solving skills.
Proficient in data reporting tools, EMRs, and Microsoft Office.
Ability to interpret NCQA Quality metrics and clinical documentation.
Excellent communication and collaboration abilities.
Strong organizational skills and attention to detail.
Accountability and ownership.
Critical thinking and process improvement mindset.
Ability to work independently and as part of a team.
Strong ethical standards and confidentiality awareness.
Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing.

Nice To Haves

Preferred Certifications: Medical Assistant (MA). Pharmacy Technician (CPhT). Certified Professional Coder (CPC). Certified Risk Adjustment Coder (CRC). Nursing Student. Foreign Medical Graduate.
Preferred Experience: Experience working with HEDIS, CAHPS and HOS, STARS programs. Prior role in healthcare quality, care management, or clinical support. Knowledge of value-based care models, managed care, or population health. eCW and insurance Portals experience preferred.

Responsibilities

Monitor quality metrics such as HEDIS, STAR measures, CMS and NCQA guidelines, and internal performance indicators.
Analyze care gaps and collaborate with providers, care teams, and pharmacy to close adherence and preventive care gaps.
Support quality reporting processes including dashboards, data validation, and performance summaries.
Conduct audits and chart reviews to ensure documentation of accuracy and regulatory compliance.
Inform center staff on quality measures and best practices to improve patient care outcomes.
Assist with the development and implementation of quality improvement plans and intervention strategies.
Communicate findings and trends to leadership and assist in action planning.
Maintain up-to-date knowledge of healthcare quality standards and industry requirements, including HIPAA.
Ability to multi-task efficiently and effectively.
Communicate effectively by phone and in writing with providers, pharmacies, and patients.
Adherence to all policies and procedures, including but not limited to standards for safety, attendance, punctuality and personal appearance.
Participation in medical reviews, EMR updates and any additional training regarding medical documentation.