Bilingual Quality Specialist
Listed on 2026-09-27
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Healthcare
Healthcare Administration, Healthcare Compliance
At Suvida Healthcare, we are not just caregivers; we’re compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors.
Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose?
WhatMakes Us Unique
We are an empowered primary care team, clinical operations, and support team creating health equity through an exceptional clinical and consumer experience that improves the quality of life for the people, families, and neighborhoods we serve. We tailor our primary care program to the culture, language, social, and overall well‑being of the seniors we serve.
How We WorkOur Culture & Core Beliefs
- Earn Trust
- Building Relationships
- Creating Joy
- Doing Right
- Improving Every Day
- Moving Forward
- Competitive Pay
- Free Mental Health & Life Coaching for Team Members and their Dependents
- Holiday Time Off with Pay
- Paid Community Service Day
- Paid Parental/Family Leave
- Generous Paid Time Off (PTO)
- 401k Retirement Plan with Company Match
- And much more....
The Specialist, Quality will work closely with our clinic staff to identify gaps in care, capture HEDIS documentation, perform chart audits, track patient engagement in care gap, and notify clinics of time sensitive care caps. They will also work with the Director of Quality to report low clinic engagement, opportunities for staff education, and reporting inaccuracies. Essential responsibilities consist of, but are not limited of the following:
Responsibilities- Identify and notify clinical staff of next steps needed to address open quality gaps.
- Submit documentation to payer portal to close quality gaps.
- Audit supplemental data to ensure results are compliant for identified measures.
- Educate staff and providers on HEDIS technical specifications.
- Resolve clinical staff Quality inquiries.
- Join daily huddles as needed to inform clinical staff of patients with outstanding time sensitive measures.
- Collaborate with other departments on quality specific projects to help reach quality goals.
- Actively participate as a team player to promote positive health outcomes for our patients.
- Able to work Monday-Friday from 8-5PM and be in the Arizona area.
- Be willing to take on additional task to support the overall success of the organization.
- 10% travel within Arizona
- Bachelor's degree in healthcare administration or public health required
One of the following certifications, accompanied by 2+ years of experience in value-based care setting (primary care or Medicare Advantage Plans preferred):
- Certified Medical Assistant
- Certified Nursing Assistant
- NCQA certification
- 4+ years of experience in value-based care setting (primary care or Medicare Advantage Plans preferred)
- 2+ years of HEDIS or Risk Adjustment experience in supplemental data and chart reviews
- Knowledge of CMS STARS program
- Must have a basic understanding of billing and claims coding
- Experience reviewing Electronic Medical Records
- Intermediate level experience in…
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