Clinical Quality Improvement Coordinator

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence, aiming to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine. It leverages AI, predictive analytics, and remote health guides to build stronger connections with patients and providers.

Location: Remote

Salary: $28–$30 per hour paid bi-weekly

Responsibilities

• Work in a fully remote environment and virtually engage with company and team.
• Serve as Subject Matter Expert on QI measures, services, customers, and quality initiatives.
• Conduct proactive patient outreach to identify and address quality gaps, educate on preventive care, schedule screenings, and facilitate treatment adherence.
• Collect quality data from EMR, claims, and provider outreach.
• Manage daily work using multiple systems including EMR, payer portals, vendor platforms, Guidehealth applications, and Microsoft 365.
• Work with patient lists, gap lists, sourced health data, and medical records.
• Leverage quality resources to ensure accuracy and completeness of work according to NCQA/HEDIS specifications.
• Prioritize work to meet quality reporting deadlines.
• Communicate quality performance, barriers, and improvement strategies internally and with customers.
• Follow policies and procedures for QI workflows.
• Collaborate with customers, payers, and co-workers.
• Participate in webinars, trainings, and support calls.
• Develop positive relationships with co-workers, customers, and providers.

Requirements

• Associate degree or greater in related field or certified/licensed professional (CMA, LPN).
• 1-3 years of healthcare experience including charting, data abstraction via EMR, medical terminology, quality measures, billing/coding.
• At least 2 years’ experience in Medicare Advantage Quality data abstraction and patient outreach.
• Tech-savvy in managing health data, Excel, PowerPoint, and navigating multiple systems.
• Strong verbal and written communication skills.
• Attention to detail, organized, and able to meet deadlines.
• Ability to collaborate effectively with management, co-workers, and customers.
• Periodic travel with valid driver’s license and vehicle.

Benefits

• Work from Home: Fully remote work environment.
• Comprehensive Medical, Dental, and Vision plans.
• 401(k) with 3% employer match.
• Life and Disability insurance, voluntary Life options.
• Employee Assistance Program (EAP).
• Paid time off for work-life balance.
• Paid parental leave.
• Resources for professional growth and development.

Additional Information

• The role pays $28–$30 per hour, paid bi-weekly.
• Full-time employees (30+ hours/week) are eligible for benefits; temporary employees and contractors are not.
• Diversity, inclusion, and belonging are core values.
• Position involves following all security policies to protect PHI and PII.
• Guidehealth verifies candidate identity to safeguard data and compliance.
• Employees must have internet with minimum 100 Mbps download and 10 Mbps upload.
• Employees are asked to disclose secondary employment and be available during working hours.