Quality Assurance Coordinator; Modesto

Brief Description

Healthy

U Clinics is committed to revolutionizing patient care by providing high-quality, patient-centered services in a compassionate and efficient manner. Our multi-specialty clinics offer a broad range of healthcare services, ensuring that our patients receive the best possible treatment and support. Our team is dedicated to creating a positive and collaborative work environment, where employees are valued, empowered, and supported in their professional growth.

The Clinical Quality Assurance Coordinator plays a pivotal role in ensuring the organization meets clinical quality goals, regulatory requirements, and performance metrics tied to value-based care contracts. This role supports the implementation and monitoring of quality improvement initiatives and serves as a liaison between clinical teams, health plans, and data analysts.

• Support quality improvement initiatives aimed at achieving VBC program targets (e.g., HEDIS, Stars, ACO, CMS measures).
• Coordinate chart reviews, clinical documentation audits, and data validation processes.
• Partner with providers and care teams to improve performance on preventative care, chronic disease management, and care gap closure.
• Assist in delivery of provider and staff education on clinical quality standards and documentation best practices.
• Manage submissions of quality data to payers and regulatory bodies in accordance with contract and compliance timelines.
• Maintain knowledge of evolving value-based care models, clinical quality metrics, and regulatory requirements.
• Serve as a resource for clinical teams on quality improvement strategies and evidence-based practices.
• Support patient engagement efforts tied to quality goals, such as outreach for screenings, immunizations, and wellness visits.
• An expert in value based primary care measures, care gap outreach and closure guidelines. This role is responsible for phone outreach to patients for care gap management, medication adherence, suspect condition assessment, and communicating critical information to stakeholders. The ideal candidate must be very comfortable with outbound phone communication.
• All other duties as assigned.

• Certification in Medical Assisting, Healthcare Administration, Public Health, or related field.
• 2+ years of experience in healthcare quality improvement, preferably in a value-based care or managed care environment.
• Strong knowledge of HEDIS, Stars, CMS, NCQA, and other quality performance programs.
• Experience working with EMRs, data analytics tools, and clinical workflows.
• Excellent communication, organization, and problem-solving skills.
• Ability to work independently and collaboratively in a fast-paced environment.
• Experience with population health management tools and care coordination programs.
• Familiarity with ACO, PCMH, MSSP, or Medicare Advantage quality programs.
• Bilingual in English and Spanish preferred.

Healthy

U Clinics reserves the right to adjust this role based on business needs. Revised 01/01/2026