<p>A large integrated Medicare-focused medical group is recruiting a <strong>Clinical Quality Consultant I</strong> based in <strong>Orlando, Florida</strong> to serve as the primary Stars and HEDIS subject-matter expert across assigned markets. This hybrid role sits at the intersection of data analytics, provider engagement, and quality improvement — driving performance toward a minimum 4-Star CMS rating through hands-on collaboration with provider groups, regional operations, and a corporate quality matrix team. The position offers a clear professional development pathway within one of the largest Medicare Advantage networks in the country.</p>
<h3>Perks and Benefits</h3> <ul> <li>Hourly pay range of $24–$43 per hour based on full-time employment, commensurate with local labor market, education, and experience</li> <li>Comprehensive benefits package including medical, dental, and vision coverage (subject to eligibility requirements)</li> <li>401(k) with company contribution</li> <li>Employee stock purchase plan (equity participation)</li> <li>Incentive and recognition programs tied to performance</li> <li>Access to development opportunities for advancement into additional roles within the organization</li> <li>Drug-free workplace; pre-employment drug screening required</li> </ul>
<h3>Practice Highlights</h3> <ul> <li>Hybrid schedule: three in-office days per week with approximately 75% travel within Orlando and surrounding areas</li> <li>Serves as the primary point of contact for all Stars-related activities within assigned market(s), operating within a matrix relationship spanning Quality corporate operations and Regional/Market operations</li> <li>Drives market-level business plans designed to motivate provider engagement and achieve a minimum 4-Star CMS rating</li> <li>Performs data mining to identify quality gaps, develop remediation plans, and build tools and databases to capture relevant performance data for each assigned provider group</li> <li>Provides analytical interpretation of Stars and HEDIS reporting, including executive summaries delivered to health plan leadership and provider groups</li> <li>Collaborates directly with regional Education Consultants on outlier identification, barrier discussions, and targeted education initiatives</li> <li>Partners with the Corporate Quality team on enterprise-wide quality initiatives and CAHPS/HOS action planning</li> <li>Reviews provider group structure, office operations, and personnel to identify the most effective engagement strategies and solution-based, user-friendly practice improvement tools</li> <li>Focused on the Medicare Advantage market with solid understanding of managed care requirements, products, and competitive landscape</li> </ul>
<h3>Qualifications</h3> <ul> <li>Minimum 1 year of experience in healthcare or a health plan environment</li> <li>Minimum 1 year of HEDIS experience and/or demonstrated HEDIS knowledge</li> <li>Solid knowledge of managed care requirements related to clinical quality and the Medicare market</li> <li>Experience working in managed care with network and provider relations functions</li> <li>Demonstrated professional experience influencing and persuading behavioral change among providers and clinical staff</li> <li>Microsoft Office proficiency with exceptional attention to detail</li> <li>Preferred: clinical and/or health education background; knowledge of clinical standards of care, preventive health, and Star measures</li> <li>Preferred: proven ability to analyze complex, cross-functional process problems and implement actionable solutions; strong communication, presentation, and relationship-building skills with both clinical and non-clinical personnel</li> <li>Preferred: demonstrated business acumen in the Medicare space</li> </ul>
<h3>About the Community</h3> <p>Orlando, Florida offers a dynamic lifestyle anchored by year-round warm weather, no state income tax, and one of the most diverse metropolitan economies in the Southeast. The greater Orlando area provides access to world-class entertainment, a robust arts and dining scene, top-rated school districts in surrounding communities, and easy reach to both Atlantic and Gulf Coast beaches. For clinicians and healthcare professionals relocating from higher cost-of-living markets, Orlando represents a compelling combination of professional opportunity and quality of life.</p>