Job Description:
About the role
In collaboration with the Manager, the Sr. Associate, Quality Operations acts cross-functionally to drive Cityblock’s quality performance in alignment with organizational objectives and contractual standards. The role advances HEDIS/Stars operational excellence by maintaining quality payor partnerships, managing vendor relations, supporting key quality initiatives, and delivering centralized, standardized support to local market and clinical teams.
Responsibilities
- Serve as Quality SME for HEDIS/Stars specifications
- Payor Relationship Management
- Lead quality meetings for all payor partners to discuss Cityblock’s quality performance and shared priorities with plan partner
- Support regular check-ins, quality initiatives, quality data sharing, and other ad hoc requests
- Coordinate responses to payor requests, audits, and quality-related inquiries
- Possess a deep understanding of contractual obligations
- Vendor Operations
- Act as liaison for external vendors to support quality initiatives
- Oversee vendor performance, ensuring timely deliverables and adherence to contractual expectations
- Collaborate with Product, Data Platform, and other internal teams to ensure efficient operations
- Centralized Quality Support and Education:
- Provide centralized quality support to markets to ensure cross-organizational alignment and supporting coordination between quality, markets, and clinical teams
- Analyze quality metrics and collaborate with markets as needed to achieve performance goals
- Serve as a resource for quality support throughout all levels of the organization, e.g. replying to market requests, monitoring questions and feedback received in the quality-support slack channel, etc.
- Work closely with market teams to ensure provider and care team documentation meets HEDIS standards and supports effective gap closure.
- Performance Improvement Workgroups:
- Support roll-out of quality strategic initiatives
- Develop and support new processes and workflows to address Quality needs, and continuously monitor performance
- Pilot new market-level initiatives and distill learnings to apply best practices towards national quality operations
- Generate actionable insights and performance reporting to support market leaders in identifying, implementing, and tracking quality improvement initiatives.
Requirements
- Bachelor's degree
- 3+ years of experience in HEDIS/Stars; broader experience in quality improvement, quality management, and/or population health management
- 3+ years of experience in Medicare, ACA, Marketplace, and/or Medicaid lines of business
- Experience managing external partner relationships (health plans and/or vendors), including contractual/SLA oversight, combined with the ability to analyze quality data and translate it into actionable reporting (Excel/SQL or similar)
- Experience designing, piloting, or improving operational workflows in a healthcare quality setting; CPHQ or equivalent certification a plus
We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:
$64,000.00 - $82,000.00 Annual
Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.
