Quality Improvement Data Coordinator - Medicare Advantage

Company Description

WHO IS GUIDEHEALTH? 

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. 

Job Description

As outlined below, provide quality improvement focused work for all delegated entities and support for ACO quality reporting for all contracted ACOs.

WHAT YOU’LL BE DOING

• Work in a partially remote environment, collaborating with team members virtually each day.
• Serve as a Subject Matter Expert (SME) on quality improvement measures, customer needs, and payer‑specific quality initiatives across commercial and government programs.
• Travel to provider offices to support quality efforts, including completing on‑site eye exams (training provided), scanning records, and coordinating medical record management.
• Conduct proactive patient outreach to identify and close quality gaps—educating patients, scheduling screenings, supporting treatment plan adherence, and improving outcomes.
• Collect and abstract quality data using EMRs, claims information, and provider engagement.
• Use multiple platforms daily, including EMR systems, payer portals, vendor tools, GuideHealth applications, and Microsoft 365 (Excel, Word, PowerPoint, Teams).
• Work with various health data sources, including patient lists, gap lists, and medical records.
• Apply all available quality resources—NCQA/HEDIS® specifications, coding materials, and Guides—to ensure accuracy and completeness.
• Prioritize tasks to meet strict reporting timelines and quality program requirements.
• Communicate performance trends, barriers, and improvement strategies to internal teams and external partners.
• Follow established QI workflows, processes, and best practices.
• Collaborate daily with customers, payers, and internal teams.
• Participate in payer and departmental trainings, webinars, and support calls.
• Represent GuideHealth professionally and build positive working relationships with providers and staff.

Qualifications

WHAT YOU'LL NEED TO HAVE

• Associate degree or higher, or a clinical license/certification (CMA, LPN).
• 1–3 years of healthcare experience, including EMR use, medical terminology, chart review, and familiarity with quality measures or billing/coding.
• Minimum 2 years of Medicare Advantage quality data abstraction and patient outreach experience.
• Strong technical ability—comfortable working with health data, Excel, PowerPoint, and multiple digital systems.
• Excellent verbal and written communication skills.
• High attention to detail, strong organization, and the ability to meet strict deadlines.
• Ability to work collaboratively across teams and with external partners.
• Valid driver’s license and personal vehicle; travel required and reimbursed.

WOULD LOVE FOR YOU TO HAVE

• Certified/licensed professional-CMA, LPN
• Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers.
• Extensive experience with quality database entries and reporting.
• Experience in interpreting and reporting quality information, as well as training staff.
• Proficiency in Electronic Medical Record (EMR) software and cloud platforms

WHAT YOU GET

• Use your skills to make a meaningful impact in healthcare.
• Work with a great team in an awesome work environment.
• Competitive compensation.
• Great benefits like flextime time off.

Additional Information

The base pay range for this role is between $28-$32 per hour paid bi-weekly

ALIVE with Purpose: How We Thrive at Guidehealth 

At Guidehealth, our values come to life in everything we do. 

• We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. 
• Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. 
• With Collaborative