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Quality Assurance Specialist Lead

Orlando, United States

Job Description – Clinical Quality Improvement Lead

Reports to: Sr. Director of Quality Assurance

FLSA Status: Exempt

Position Summary

The Clinical Quality Improvement Lead oversees workflows, documentation, and clinical operations, ensuring staff compliance with payer and quality requirements while supporting initiatives that improve patient outcomes.

Primary Responsibilities

  • Conduct patient outreach to close care gaps and improve STARs performance.
  • Lead clinical campaign initiatives including vaccines, A1c, hypertension, and cancer screenings.
  • Oversee daily clinical workflows for efficiency and compliance.
  • Review documentation for completeness and HEDIS alignment.
  • Monitor ER utilization and inpatient follow-ups.
  • Upload compliant outcomes to payer portals.
  • Educate and train staff on workflows and compliance.
  • Develop corrective action plans with leadership.
  • Conduct site visits (75% travel) to monitor compliance and support operations.

Qualifications

Education & Certification

  • Active LPN license required; RN preferred.

Experience

  • Experience in quality assurance, HEDIS, or workflow management required.
  • Experience in staff education and compliance monitoring beneficial.

Skills & Knowledge

  • Strong knowledge of HEDIS, STARs, and payer programs.
  • Excellent communication and training skills.
  • Proficiency in EMR and Microsoft Office Suite.
  • Bilingual (English/Spanish) preferred.

Core Competencies

  • Leadership and staff development
  • Attention to detail
  • Analytical and problem-solving
  • Communication and collaboration

Core Values & Behaviors

Integrity
Acts honestly, ethically, and builds trust with patients, staff, and partners. Maintains confidentiality and consistently upholds organizational standards.

Compassion
Demonstrates empathy, kindness, and understanding in all interactions, ensuring patient-centered care in every engagement.

Accountability
Takes responsibility for actions, decisions, and outcomes, maintaining ownership of assigned duties and quality standards.

Respect
Treats patients, families, and colleagues with dignity and professionalism, fostering a culture of inclusion and collaboration.

Excellence
Strives for the highest quality in clinical care, operations, and performance, promoting continuous improvement and innovation.

Work Environment / Physical Demands

This role requires frequent use of computers, standing, and walking. May occasionally lift or move items up to 25 lbs. Travel to clinical sites for audits, training, and monitoring is required.

Travel Requirements

This position requires up to 75% travel across practice sites.

Schedule / Hours

This is a full-time position, Monday through Friday, with occasional evenings or weekends to meet organizational priorities.

Equal Employment Opportunity Statement

We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Salary Range (50th Percentile Philosophy – Florida)

Minimum: $60,000
Midpoint: $65,000
Maximum: $70,000

This range aligns with Florida market benchmarks and Nuvia Medical’s compensation philosophy of paying at the market median.

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