Quality and Process Improvement Specialist

Health Solutionsis a premier wellness center focused on whole person care. With over 400 employees in Southern Colorado you would be joining a mighty team of support and administrative staff clinicians physicians nurses and others in our efforts to improve the health and wellbeing of our community.

Were hiring a full-time Quality and Process Improvement Specialistto join our Quality and Compliance group located at 41 Montebello Pueblo CO 81001.

What Youll Be Doing

Under the supervision of the Vice President of Quality Improvement and Process Improvement the Quality and Process Improvement Specialistleads agency-wide initiatives to enhance clinical and operational performance. This role applies evidence-based quality improvement methodologies to optimize workflows ensure regulatory compliance and support audit readiness and performance reporting. The specialist collaborates across departments to improve care delivery in both primary care and behavioral health settings promoting integrated care best practices and fostering a culture of continuous improvement.

RESPONSIBILITIES: The Quality and Process Improvement Specialist drives agency-wide efforts to enhance both clinical and operational performance. This role applies proven quality improvement methodologiessuch as PDSA Lean/Six Sigma and IHI approachesto optimize workflows ensure regulatory compliance support audit readiness and contribute to performance reporting. The specialist collaborates across departments to improve care delivery in primary care and behavioral health settings while fostering a culture of continuous improvement throughout the organization.

• Lead quality improvement initiatives using frameworks such as PDSA Lean/Six Sigma or IHI methods to achieve measurable outcomes and process enhancements.
• Track and report on clinical quality measures including HEDIS CCBHC eCQMs and UDS utilizing data analysis to drive informed decision-making.
• Collaborate with interdisciplinary teams to continuously improve care delivery and implement best practices in both primary care and behavioral health environments.
• Ensure ongoing compliance with RAE/BHASO and state regulations including Behavioral Health Administration (BHA) and Health Care Policy and Financing (HCPF) requirements.
• Conduct root cause analyses (RCA) and develop corrective action plans in response to identified issues or process gaps.
• Validate electronic health record (EHR) data integrity and accuracy through systematic documentation audits and technical reviews.
• Support organizational accreditation and grant reporting efforts such as PCMH NCQA and HRSA by preparing and submitting required documentation.
• Deliver comprehensive education and training for staff on Quality Improvement tools coding and documentation best practices and evidence-based methodologies in accordance with regulatory and funding standards.
• Facilitate process improvement projects and drive continuous improvement by identifying opportunities for innovation and ensuring deliverables are met within scope and timeline.
• Design implement and monitor action plans based on audit findings and compliance reviews to improve service delivery documentation and billing practices.
• Prepare and distribute daily weekly and quarterly reports of audit and performance findings offering actionable insights for leadership and teams.
• Advise and collaborate with the Vice President of Quality Improvement and Project Management on identifying and addressing quality opportunities across the agency.
• Undertake additional duties as assigned to further organizational goals and enhance the quality improvement program

Desired attributes:

• Adaptability: Embraces workplace change as an opportunity for innovation and creativity.
• Problem-Solving: Takes ownership of issues identifies solutions applies sound judgment and demonstrates consistent follow-through.
• Professional Growth: Demonstrates job knowledge performs fundamental functions and is willing to assume greater responsibilities over time.
• Collaboration: Inspires and models teamwork to achieve shared goals.
• Customer Service: Exhibits politeness helpfulness flexibility and trust-building while maintaining appropriate boundaries.
• Behavioral Health Insight: Understands behavioral health clinical practices and their impact on quality and performance.

What were looking ForThe Must-Haves

• Bachelors degree in public health Healthcare Administration Nursing Social Work or related field.
• Minimum of 2 years of experience in healthcare quality or performance improvement.
• Comprehensive knowledge of clinical workflows in primary care and behavioral health.
• Familiarity with state/federal reporting requirements.
• Proficiency in Microsoft Office particularly Excel and experience with EHR systems.
• Valid drivers license and reliable transportation.

What wed Like to See in youthe Nice-to-Haves

• Masters degree (MPH MHA MSW MBA or similar).
• Certification in CPHQ Lean Six Sigma (Green or Black Belt) or equivalent certification.
• Experience in CCBHC or FQHC environments.
• Familiarity with NCQA standardsRegional Accountable Entities (RAE) Behavioral Health Administration Service Organization (BHASO) and behavioral health metrics.

Health Solutions expects all staff to

• Adapt to change in the workplace and use change as an opportunity for innovation and creativity
• Take ownership of problems brainstorm problem resolutions and use sound judgment in selecting solutions to problems and demonstrate consistent follow-through
• Possess the job knowledge and skills to perform the fundamental job functions and willingly assume greater responsibility over time regarding the scope of work
• Inspire and model collaborative teamwork and Human Kindness
• Demonstrate accommodation politeness helpfulness trust-building appropriate boundaries and flexibility in customer service

Closing Date: Open until filled EOE M/F