[Hiring] Quality Improvement Provider Strategist @UPMC

Role Description

UPMC Health Plan is hiring a full-time Quality Improvement Provider Strategist to join the Quality Improvement team. This is a remote role that works Monday - Friday daylight hours EST.

The Quality Improvement Provider Strategist serves as a central resource for strategic planning related to provider network performance on primary care provider quality measures. This role integrates quality strategy, data analysis, opportunity identification, and performance intelligence to translate complex data into clear, actionable strategies that drive consistent and effective execution across the provider network.

Responsibilities:

• Analyze quality performance data at the ISD, regional, and provider levels to identify trends, risks, gaps, and improvement opportunities.
• Establish and communicate annual organizational quality priorities, quarterly quality priorities, and provider level focus areas.
• Partner with line of business leaders, product teams, and internal stakeholders to align current and future quality initiatives into a cohesive, provider focused strategy and message to be shared with providers.
• Deliver tailored insights and recommendations to diverse audiences including executive leadership, provider-facing network staff, and provider groups, to support informed decision making and measurable improvement.
• Identify systemic barriers and root causes (e.g., workflows, access, data integrity, patient engagement, and coding) through structured collaboration and governance processes.
• Operate effectively within a matrixed organization, influencing outcomes without direct authority and clearly communicating complex information.
• Serve as the primary quality strategy resource and best practices advisor for Provider Network Liaisons supporting primary care practices.
• Maintain comprehensive tracking and reporting of quality improvement activities, progress, and outcomes.
• Collaborate with provider facing teams to assess current workflows and facilitate redesign efforts that promote best practices, data driven decision making, and effective tool utilization.
• Apply continuous quality improvement methodologies to support sustainable change and performance improvement.
• Act as the clinical and quality SME for Medicare Stars, HEDIS, and DHS programs.
• Support Provider Network Liaisons and provider offices in the use of population health management and quality tools sponsored by UPMC Health Plan.
• Provide onsite or virtual support for quality gap closure activities, including data mining, manual documentation review, and EMR based opportunity analysis.
• Escalate issues and feedback as appropriate and support timely, data informed decision making.
• Deliver concise, timely status updates and reporting.
• Assist in the development and maintenance of provider educational materials.
• Design and facilitate quality focused training for internal Health Plan staff.
• Demonstrate excellent written and oral presentation skills in all communications.

Qualifications

• 3 years of experience in managed care and/or physician practice management.
• Clinical training and/or demonstrated experience working in outpatient clinical settings.
• Bachelors degree in business, healthcare, nursing, mathematics, statistics, management, or a related field.
• Hands-on experience with HEDIS or quality improvement within a healthcare setting strongly preferred.
• Advanced proficiency in Microsoft Excel and PowerPoint preferred.
• Ability to plan and manage large scale initiatives, balancing scope, timelines, and collaboration with multiple stakeholders.

Licensure, Certifications, and Clearances

• UPMC is an Equal Opportunity Employer/Disability/Veteran.
• Must be legally authorized to work in the United States, without requiring, now or in the future, sponsorship for employment visa status.
• UPMC does not participate in STEM OPT.