Senior Specialist, IPA Quality & Performance

The role

The Senior Specialist, IPA Quality & Performance drives quality, cost, and risk adjustment results across the Chaffey Medical Group and My Family Medical Group IPA networks. This role develops performance plans, leads practice engagement, and serves as the quality contact for contracted health plans.

What you will do

• Develop and execute annual quality, cost, and risk adjustment performance plans for each IPA
• Segment practices by membership, performance, and dollars at stake
• Build and sustain working relationships with physician owners, office managers, and front-line staff
• Lead practice visits, performance reviews, and education on measure requirements
• Design and run practice incentive and recognition programs
• Direct gap-closure strategy across HEDIS, Star Ratings, Part D adherence, and patient experience measures
• Partner with Utilization and Care Management to build practice-specific improvement plans
• Drive practice engagement in Annual Wellness Visit completion and chronic condition recapture
• Serve as the named health plan contact for quality performance and audits
• Provide day-to-day work direction to the HEDIS Coordinator and HIM quality queue

Required qualifications

• Bachelor’s degree in health administration, public health, nursing, business, or a related field
• Five or more years of value-based care quality experience in an IPA, MSO, health plan, ACO, or medical group
• At least three years of provider-facing performance improvement with independent or contracted practices
• Demonstrated record of improving HEDIS or Star Ratings results through practices not directly managed
• Working knowledge of HEDIS specifications, CMS Star Ratings methodology, CMS-HCC risk adjustment, and the California delegated managed care model
• Experience presenting performance data to physicians, practice owners, and health plan quality leaders
• Advanced Excel skills
• Experience with population health or quality platforms such as Cozeva
• Valid California driver’s license
• Reliable transportation
• Ability to travel regularly to practice sites

Nice to have

• Master’s degree (MHA, MPH, MBA, MSN, or related)
• Certified Professional in Healthcare Quality (CPHQ)
• Certified Risk Adjustment Coder (CRC)
• Certified Professional Coder (CPC)
• Experience with the IHA Align. Measure. Perform. program and Medi-Cal Managed Care Accountability Set measures
• Formal improvement methodology training (Lean, Six Sigma, or PDSA)
• Bilingual English/Spanish

Benefits

• Stock-options package
• Health benefits include medical, dental and vision
• 401K
• Long-term disability
• Unlimited PTO
• Life insurance
• Paid Leave Program

About the company

Akido builds AI-powered doctors and is the first AI-native care provider. It serves 500K+ patients across California, Rhode Island, and New York.