Quality Performance Specialist

About Vytalize Health: Vytalize Health is a leading, rapidly growing value-based healthcare organization dedicated to transforming ambulatory practice delivery networks into high-performing clinical systems. By equipping independent primary care practices with data analytics, dedicated clinical teams, and custom patient outreach tools, we optimize financial risk setups and clinical care metrics across lines of business including MSSP, ACO REACH, Medicare Advantage, Commercial, and Medicaid contracts.

Role Mission

We are seeking a data-informed and highly structured Quality Performance Specialist to own and drive quality performance improvement across our clinical practice network. Operating within our centralized VBC Performance department, you will serve as a key consultant and operational partner to primary care groups—providing active provider education, HEDIS/Stars performance insights, and workflow gap closure guidance. This position is built for a professional who loves parsing electronic health record data pipelines, troubleshooting data discrepancies, and configuring high-impact clinical interventions.

Key Responsibilities

• Practice Performance Auditing: Identify high-impact operational gaps and engineer practice-specific quality remediation plans. Lead rigorous quarterly and monthly performance reviews for underperforming clinical groups.
• Workflow Optimization & Education: Provide continuous mentoring to primary care providers and staff regarding value-based care performance benchmarks, CPT II clinical coding adoption, and preventative care gap closures.
• EHR Data Integrity & Diagnostics: Investigate and troubleshoot tracking discrepancies flashing between live Electronic Health Record (EHR) databases, internal population health platforms, and payer performance scorecards.
• Chart Validation & Submissions: Conduct focused clinical chart reviews and data validation loops to confirm documentation accuracy, support electronic reporting requirements (eCQMs), and maximize risk adjustment scores.
• Cross-Functional Payer Alignment: Represent the group in payer-hosted quality clinics, aligning patient outreach strategies with localized practice barriers and changing state compliance criteria.

Required Skills & Qualifications

• 3+ years of progressive professional experience operating inside healthcare quality management, population health operations, ambulatory practice consulting, or value-based care tracks.
• Demonstrated experience navigating federal and commercial quality frameworks—specifically MSSP, ACO REACH, or Medicare Advantage (HEDIS / Star Ratings).
• Direct experience engaging, training, or collaborating with primary care physicians, clinicians, and administrative medical billing staff.
• Fluency reading EHR infrastructure schemas, clinical documentation workflows, and multi-tier quality reporting timelines.
• Strong analytical ability to interpret complex data grids and translate telemetry into clear, actionable advice for non-technical clinical groups.
• Excellent verbal presentation, onboarding facilitation, and relationship-building skills to drive organizational change.
• Location Context: 100% remote working flexibility setup tailored for qualified professionals operating from the United States.

Preferred Advantages (Nice to Have)

• Advanced operational experience handling CPT II medical coding and clinical documentation optimization strategies.
• Deep understanding of digital quality measures, eCQMs configurations, and electronic registry submission parameters.
• Certified Professional in Healthcare Quality (CPHQ) credential or a related clinical validation certification.
• Advanced analytical proficiency navigating complex Microsoft Excel modeling loops or similar healthcare intelligence instruments.

What We Offer

• Competitive base compensation package matched with annual target bonus potential tiers.
• Comprehensive health, dental, and vision benefits fully activated on your official start date.
• Dedicated Health & Wellness stipend allocating up to $300 per quarter starting day one.
• 401K retirement framework with a 100% employer match up to 4% of annual baseline salary.
• 5 paid sick days alongside an unlimited/generous paid "Vytal Time" off allocation loop following your initial 90 days.
• Company-paid Short-Term Disability (STD) and Long-Term Disability (LTD) backup packages.
• Complete corporate home office technology equipment setup delivered directly to your remote location.