Quality Specialist

Company Description Amada Health IPA - Medicare Advantage PlanRole Description The Quality Specialist is a full-time, on-site role based in Fresno, CA. Job Summary:Responsible for supporting quality improvement initiatives, monitoring compliance with healthcare standards, analyzing performance data, and working with providers and internal teams to improve quality outcomes and member satisfaction.Key Responsibilities:* Monitor provider and healthcare quality metrics and performance.* Review medical records, claims, and other documentation for quality and compliance.* Support HEDIS, STARS* Identify gaps in care and coordinate corrective action plans.* Track provider performance and follow up on quality concerns.* Assist with audits, regulatory requirements, and compliance activities.* Prepare quality reports, spreadsheets, and presentations for leadership.* Work closely with Provider Relations,