Medical Assistant - Quality Coordinator

Job Summary

We are seeking a detail-oriented and highly organized Medical Assistant-Quality Coordinator to support and enhance quality performance initiatives related to HEDIS, Medicare STAR Ratings, and risk adjustment programs. This role plays a key part in improving clinical quality outcomes and ensuring compliance with NCQA and CMS guidelines. The ideal candidate will serve as a liaison across multiple stakeholders—including provider offices, members, coders, and audit teams—to close care gaps, maintain documentation integrity, and promote high standards of healthcare quality.

Responsibilities:

• Monitor and evaluate quality performance metrics across HEDIS, CMS 5-STAR Ratings, and Pay-for-Performance (P4P) programs, ensuring alignment with NCQA and regulatory standards.
• Assist with the collection, abstraction, and analysis of medical records and data to support HEDIS reporting and STAR measure improvement.
• Collaborate with provider offices, coders, and billing teams to identify and resolve documentation discrepancies and support accurate coding for HCC and Risk Adjustment programs.
• Retrieve, review, and track electronic health records and coordinate with external sources to obtain clinical documentation required for quality reporting.
• Facilitate outreach and communication efforts with members and provider teams to address open care gaps, encourage preventive services, and improve medication adherence and other STAR-related measures.
• Partner with internal audit teams to ensure quality assurance and regulatory compliance across documentation and reporting workflows.
• Maintain accurate records and participate in continuous quality improvement projects and administrative functions as needed.

Qualifications:

Strong understanding of the healthcare industry, including:

• HEDIS, STAR Measures, and NCQA Quality Standards
• Risk Adjustment and Hierarchical Condition Categories (HCC)
• Value-based care initiatives

Demonstrated ability to manage multiple priorities effectively with exceptional attention to detail.

Excellent organizational and time management skills.

Strong analytical thinking with the ability to conduct audits and investigations to identify gaps and trends.

Professional written and verbal communication skills; ability to interact with internal teams, providers, and patients in a respectful and effective manner.

Able to work independently with minimal supervision while supporting broader team goals.

Customer service experience with a proactive and courteous approach under pressure.

Familiarity with medical terminology and prior experience reviewing clinical documentation is highly desirable.

Preferred Education & Skills:

· Certified Medical-Assistant

· High School Diploma or GED required; some college coursework preferred.

· Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).

· Experience working with EMRs or EHRs (Electronic Medical Records/Health Records) preferred.

· Ability to read, write legibly, and communicate clearly in English with professional quality.

· Prior experience supporting quality improvement or care management programs is a plus.

Job Type: Full-time

Pay: From $24.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Ability to Commute:

• Sacramento, CA 95833 (Required)

Work Location: In person

Salary : $24