New

NCQA Quality Improvement Specialist

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Apr 23, 2026
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. This role is collecting and reviewing NCQA documentation from stakeholders throughout MGB Health Plan. This person will be a resource about NCQA requirements to stakeholders throughout MGB Health Plan. The NCQA Quality Improvement Specialist plays a key role in ensuring that the department performs at the highest levels on standardized, national measures of clinical care quality and accreditation. Ensures the accurate and timely collection of data from clinical records, identifies opportunities for improvement, communicates and works collaboratively with multidisciplinary improvement teams and facilitates the creation and implementation of improvements in care processes. Essential Functions -Assist with the development and coordination of all documentation needed to successfully maintain NCQA accreditation. -Support the development of quality improvement performance, audit function processes, and tools -Assist in designing, running, managing, and the data review process for assuring accuracy and integrity of health services data reports to meet regulatory and operational requirements -Report outcomes and quality monitoring results to management -Assist with managing databases, policies, and procedures related to assigned areas -Assist with related activities for various committees and meetings for assigned areas -Support vendor/delegate oversight. -Consults on quality issues and develops solutions Education Bachelor's Degree required; experience can be considered in lieu of education Experience Experience in Quality Improvement, preferably in a healthcare setting 2-3 years required. NCQA Health Plan and/or Health Outcomes Accreditation experience highly preferred. Knowledge, Skills, and Abilities Demonstrated knowledge and use of quality improvement methodologies and tools. Must have strong interpersonal skills necessary to establish supportive, collegial relationships, and to interact effectively with administrative and clinical leadership, staff, clinical leads, and other healthcare professionals. Ability to manage multiple projects simultaneously and adhere to work deadlines. Excellent verbal and written communication skills. Excellent computer skills including Microsoft Office (Word, Excel, PowerPoint, Access), Flowcharting/mapping (QI Charts). Ability to learn and effectively use computer software, such as electronic health records and data entry tools. Working Conditions This is a remote role that can be done from most US states This role is Monday through Friday, business hours EST Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.