Guidehealth is hiring a Remote Clinical Quality Improvement Coordinator

Responsibilities

• Perform all duties remotely, engaging virtually with the company and team on a daily basis.
• Serve as the subject matter expert on quality measures, services, customers, and initiatives for both commercial and governmental payers.
• Proactively reach out to patients to identify and address quality gaps, educate them on preventive care, schedule screenings or appointments, and support treatment plan adherence to improve outcomes.
• Collect quality data from electronic medical records, claims, and provider outreach.
• Manage daily tasks using multiple systems including EMR platforms, payer portals, vendor tools, Guidehealth applications, and Microsoft 365 for Excel, Word, PowerPoint, and Teams.
• Work with patient lists, gap lists, health data, and medical records on a regular basis.
• Utilize all quality-related resources such as measure instructions, NCQA/HEDIS specifications, coding documents, and quick reference guides to ensure accuracy and completeness.
• Prioritize daily work to meet various quality reporting deadlines and requirements.
• Communicate quality performance, barriers, and improvement strategies internally and with customers.
• Follow all established policies and procedures for quality improvement workflows to ensure overall success.
• Collaborate with customers, payers, and coworkers to accomplish daily tasks.
• Participate in departmental and payer-sponsored webinars, trainings, and support calls throughout the year.
• Communicate professionally and build positive relationships with coworkers, customers, providers, and their support staff.

Requirements

• Associate degree or higher in a related field, or certification/licensure as a CMA or LPN.
• 1-3 years of healthcare experience including work with EMR systems, charting, data abstraction, medical terminology, quality measures, and medical billing/coding.
• At least 2 years of experience in Medicare Advantage quality data abstraction and patient outreach.
• Tech-savvy with health data management, Excel, PowerPoint, and navigating multiple systems and applications.
• Highly skilled in verbal and written communication.
• Strong attention to detail, organizational skills, and ability to meet strict deadlines.
• Ability to collaborate effectively with management, coworkers, and customers.

Nice to Have

• Knowledge or experience with quality improvement initiatives and data submissions required by various health insurance payers.
• Extensive experience with quality database entries and reporting.
• Experience interpreting and reporting quality information, as well as training staff.
• Proficiency in electronic medical record software and cloud platforms.

Benefits

• Fully remote work environment offering flexibility to reduce commuting and focus on professional and personal goals.
• Comprehensive medical, dental, and vision plans.
• 401(k) plan with a 3% employer match on a 6% employee contribution.
• Life and disability insurance, plus voluntary life insurance options.
• Employee Assistance Program for support during difficult times.
• Paid time off to support work-life balance and personal goals.
• Paid parental leave for new family members.
• Learning and development resources to advance your career.

Compensation

The listed compensation range is paid bi-weekly per standard payroll practices. Final base pay depends on factors including skill set, years of relevant experience, education, location, and licensure/certifications.

Work Arrangement

Remote (Worldwide)

ALIVE with Purpose: How We Thrive at Guidehealth

At Guidehealth, our values come to life in everything we do. We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare. With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member. And through Empathy in Action, we build stronger connections with those who count on us. This is what it means to be ALIVE with purpose. This is how we thrive — together — at Guidehealth.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT

Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.

OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA

This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager. As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements.

REMOTE WORK TECHNICAL REQUIREMENTS

Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.

SECONDARY EMPLOYMENT

At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest. To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.

Other

• All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits.
• The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
• Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload.
• At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest. To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.