Population Health Nurse

Overview

The Quality Improvement Nurse is responsible for driving measurable improvement in clinical quality metrics, Stars/HEDIS performance, and care gap closure aligned with payer quality incentives. This role supports population-level performance improvement with direct impact on quality revenue and value-based contract outcomes.

• Full‑Time
• Monday – Friday
• Location:
  
  Downers Grove, IL

• 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.
• A culture committed to community engagement and social impact.
• 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.

• 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.

• Bachelor’s in nursing, Preferred
• Active Registered Nurse (RN) license in good standing in the state of Illinois.

• 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…