The Quality Assurance & Improvement Specialist is a hands-on, collaborative role at Activate Care focused on maintaining and advancing the quality of clinical operations within the Path Assist program. This position bridges clinical care and data, ensuring adherence to best practices, supporting accurate reporting, and identifying opportunities to improve workflows and system efficiency.
What You'll Do
- Manage and conduct routine clinical case auditing processes to maintain high-quality clinical program operations.
- Analyze workforce compliance to ensure Community Health Workers (CHWs) maintain strict fidelity to evidence-based best practices and the specific care standards outlined in customer partnerships.
- Audit case data to ensure clinical operations meet all customer quality requirements, including industry standards like NCQA-HEDIS and Medicare Stars.
- Identify data inconsistencies, documentation gaps, and workflow errors in the care process, flagging them for review and root-cause analysis.
- Define the clinical and operational requirements for quality measurement tools, working closely with the Data Analytics team to bring those tools to life.
- Maintain, update, and own the data inputs for operational trackers and performance dashboards utilized in large-scale regional initiatives.
- Compile raw operational data into clear, trending monthly reports for internal leadership and external partners.
- Translate complex quality metrics into actionable insights and visual presentations.
- Partner closely with multidisciplinary teams, including Operations, Data Analytics, User Experience, and Product, to share audit findings and brainstorm workflow solutions.
- Support the planning and execution of continuous improvement projects aimed at increasing the quality of care, CHW team productivity, and overall system efficiency.
- Assist in designing and facilitating staff training for navigation teams when new quality standards or improved care model processes are rolled out.
- Perform other duties as assigned.
