Provider Engagement Quality Associate

Provider Engagement Quality Associate (New York City area) - Remote jobs in United States

EmblemHealth

• $56K/yr - $99K/yr

Responsibilities

• Maintain key relationships with providers, office staff and other external stakeholders
• Establish consistent communication and collaboration structure with assigned provider groups
• Build relationships with internal stakeholders (e.g. provider network, marketing) and create cross-functional teams to create a more streamlined experience for the provider
• Create and align shared understanding of quality goals
• Implement processes for two-way data sharing and work with quality data team to develop structure
• Review performance dashboards, highlight opportunities and translate findings into actionable interventions
• Monitor and track quality performance against provider contracts; make recommendations to contracts to ensure goal alignment
• Prepare reports, presentations and executive level summaries to share projects, processes, results and highlight collaboration efforts
• Create action plans and workplans to achieve performance improvement in HEDIS and CAHPS results
• Create engagement and quality educational tools which providers can utilize in their office
• Improve the understanding of quality measures through the use of educational programs (e.g. lunch and learns, webinars) and increase satisfaction and improved gap in care outcomes
• Share and roll-out provider incentive programs
• Ensure compliance with regulatory bodies and accreditation; implement corrective action and performance improvement projects as needed
• Recommend best practices and evidence-based guidelines for care integration, preventive care, care coordination and patient experience

Preferred

• Master's degree in public health, public administration, social work, health services preferred
• Quality improvement experience in a managed care environment (Preferred)
• Glassdoor
• 3.2
• New York not-for-profit health insurer offering commercial and government-sponsored plans.
• New York, New York, USA
• http://www.emblemhealth.com
• Late Stage
• Leadership Team
• Michael Collins
• Vice President IT / Customer Relationship Management Applications
• Recent News
• PR Newswire
• HealthMetrix Research Selects 2027 Medicare Advantage Plans for Exceptional Benefit Value & Overall Performance
• 2026-10-17
• The Cool Down
• In New York, 250,000 retired city workers will get $53 million back after copay suit
• 2026-08-11
• GlobeNewswire
• EmblemHealth and NewYork-Presbyterian Reach New Agreement

Qualifications

• Bachelor's Degree in a health services field required
• 3-5 years' experience in a health care related field, preferably managed care (Required)
• Proficient in Microsoft Office (Word, Excel, PowerPoint) (Required)
• Ability to develop cross-functional teams and work collaboratively with different levels of staff (Required)
• Familiar with and have a working knowledge with QI process improvement methodology strategies (e.g. PDSA) (Required)
• Possess understanding of quality measures including HEDIS®, QARR, CAHPS (Required)
• Superior planning and organizational skills to collect, organize and present information clearly (Required)
• Ability to assess all work and prioritize as necessary to meet reporting timeframes and deadlines (Required)
• Independent thinker; strong critical thinking and problem-solving skills (Required)
• Experience with and proficient in reviewing and summarizing data into actionable and simple reports and presentations (Required)
• Master's degree in public health, public administration, social work, health services preferred
• Quality improvement experience in a managed care environment (Preferred)
• 3-5 years’ experience in a health care related field, preferably managed care (Required)

Required skills

• CAHPS, HEDIS, Managed Care, PDSA, QARR

Preferred skills

• 2026-08-04, 2026-08-11, 2026-10-17, 3.2, AI Tools, Analyze How Well You Fit, Build Cover Letter, Company data provided by, Customize Your Resume, EmblemHealth and NewYork-Presbyterian Reach New Agreement, Glassdoor, GlobeNewswire, Late Stage, Leadership Team, Make your application stand out, Maximize your interview chances, Michael Collins, New York, New York, USA, PR Newswire, Recent News, The Cool Down, Understand your strength & weakness, http://www.emblemhealth.com

Experience

• 3-5 years