Quality Improvement Specialist

Quality Improvement Specialist I

Inland Empire Foundation for Medical Care (IEFMC)

Location: Riverside & San Bernardino Counties, CA

Position Type: Full-Time, Field-Based (regular travel required)

Salary: 55,000-65,000

Overview

Inland Empire Foundation for Medical Care (IEFMC) is seeking a dynamic Quality Improvement Specialist I to support physician offices and ambulatory clinics in delivering high-quality, patient-centered care. This role partners directly with providers and clinic teams to strengthen performance in HEDIS, STARS, value-based care, provider incentive programs, HCC/RAF risk adjustment, and EHR optimization. The ideal candidate excels at closing care gaps, reducing inequities, resolving billing errors, and training clinical staff.

Key Responsibilities

• Conduct on-site practice assessments and implement a standardized improvement playbook with measure-specific workflows.
• Partner with providers to identify, track, and close patient care gaps across HEDIS, STARS, and value-based care targets.
• Troubleshoot billing and claims errors related to quality reporting, risk adjustment, and incentive programs; recommend EHR workflow improvements.
• Develop and deliver webinars, in-person trainings, and individualized coaching on documentation standards, EHR workflows, and quality program requirements.
• Serve as the primary liaison for physician-based EHR implementations and support long-term adoption and optimization.
• Lead recurring performance-review meetings with practice leadership and care teams to monitor progress and identify intervention strategies.
• Utilize EHR analytics and reporting to evaluate HEDIS measures, RAF/HCC accuracy, and incentive-program metrics; recommend targeted quality-improvement actions.

Minimum Qualifications

• 3+ years of experience in an ambulatory or physician-office setting focused on quality improvement, clinical workflows, and EHR training or utilization.
• Comprehensive knowledge of:
• HEDIS, STARS, quality measures, and value-based care frameworks
• HCC/RAF risk-adjustment methodologies
• ICD-10 coding and related clinical documentation requirements
• Commercial insurance, Medicare Advantage, Medi-Cal/Medicaid program operations
• Demonstrated success in project execution, change management, and customer-focused support.
• Experience with HMO, Medi-Cal/Medicaid, Medicare, or government/public programs (preferred).
• Strong working knowledge of EHR system workflows, practice transformation, health equity strategies, and health outcomes improvement.
• Proficiency in Microsoft Word, PowerPoint, and Excel.

Preferred Qualifications

• Bachelor’s degree in Project Management, Business Administration, Health Administration, or a related field.
• Medical Assistant certification.

Physical & Travel Requirements

• Regular travel throughout Riverside and San Bernardino Counties; occasional evening meetings required.
• Ability to sit for extended periods and operate standard computer and office equipment.

To Apply

Please submit your resume.