Aptive Resources
Healthcare Quality SME
Aptive Resources, Washington, District Of Columbia, United States, 20001
Healthcare Quality Specialist
Aptive is seeking a Healthcare Quality Subject Matter Expert (SME) with specialized knowledge and expertise in healthcare quality assurance, clinical processes, healthcare regulations, and best practices. Their role is critical in ensuring that healthcare organizations deliver safe, effective, and high-value care by guiding quality improvement initiatives and compliance with regulatory standards. The SME will partner with the audit team to ensure every phase of the engagementplanning, fieldwork, and reportingreflects current clinical-quality science, evidence-based standards, and authoritative performance-measurement guidance. Primary Responsibilities Advise auditors on risk-based selection of quality domains, measures, and data sources. Refine audit objectives to align with national initiatives (MIPS, HEDIS, SAIL, etc.). Validate sampling frames and denominator/numerator logic. Mentor auditors on clinical pathways, coding nuance, and documentation standards. Troubleshoot data-quality anomalies; liaise with HIT/EHR teams to extract structured & unstructured data Apply statistical and clinical judgment to differentiate signal from noise. Conduct root-cause analysis for outlier performance; quantify impact on patient outcomes and cost. Draft clinically sound findings, recommendations, and performance-improvement plans. Present results to executive leadership and clinical governance bodies; facilitate adoption of action items. Deliver just-in-time training to audit staff on emerging quality-measurement frameworks and informatics standards (e.g., FHIR QI-Core). Contribute to lessons-learned repositories and continuous-quality-improvement (CQI) playbooks. Minimum Qualifications Master's in Public Health, Health Services Research, Health Policy, Biostatistics, or related 10 yrs designing & operationalizing quality-measure portfolios for provider or payer orgs; preferred CPHQ or FACHE Experience integrating clinical data systems to support quality-improvement & audit programs 10 yrs leading quality-of-care initiatives across multi-facility health systems Ability to obtain and maintain a public trust clearance Legal authorization to work in the U.S. About Aptive Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, we support more than a dozen agencies including Veterans Affairs, Transportation, Defense, Homeland Security and the National Science Foundation. We specialize in applying technology, creativity and human-centered services to optimize mission delivery and improve experiences for millions of people who count on government services every day. Founded: 2012 Employees: 300+ nationwide EEO Statement Aptive is an equal opportunity employer. We consider all qualified applicants for employment without regard to race, color, national origin, religion, creed, sex, sexual orientation, gender identity, marital status, parental status, veteran status, age, disability, or any other protected class. Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are highly encouraged to apply.
Aptive is seeking a Healthcare Quality Subject Matter Expert (SME) with specialized knowledge and expertise in healthcare quality assurance, clinical processes, healthcare regulations, and best practices. Their role is critical in ensuring that healthcare organizations deliver safe, effective, and high-value care by guiding quality improvement initiatives and compliance with regulatory standards. The SME will partner with the audit team to ensure every phase of the engagementplanning, fieldwork, and reportingreflects current clinical-quality science, evidence-based standards, and authoritative performance-measurement guidance. Primary Responsibilities Advise auditors on risk-based selection of quality domains, measures, and data sources. Refine audit objectives to align with national initiatives (MIPS, HEDIS, SAIL, etc.). Validate sampling frames and denominator/numerator logic. Mentor auditors on clinical pathways, coding nuance, and documentation standards. Troubleshoot data-quality anomalies; liaise with HIT/EHR teams to extract structured & unstructured data Apply statistical and clinical judgment to differentiate signal from noise. Conduct root-cause analysis for outlier performance; quantify impact on patient outcomes and cost. Draft clinically sound findings, recommendations, and performance-improvement plans. Present results to executive leadership and clinical governance bodies; facilitate adoption of action items. Deliver just-in-time training to audit staff on emerging quality-measurement frameworks and informatics standards (e.g., FHIR QI-Core). Contribute to lessons-learned repositories and continuous-quality-improvement (CQI) playbooks. Minimum Qualifications Master's in Public Health, Health Services Research, Health Policy, Biostatistics, or related 10 yrs designing & operationalizing quality-measure portfolios for provider or payer orgs; preferred CPHQ or FACHE Experience integrating clinical data systems to support quality-improvement & audit programs 10 yrs leading quality-of-care initiatives across multi-facility health systems Ability to obtain and maintain a public trust clearance Legal authorization to work in the U.S. About Aptive Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, we support more than a dozen agencies including Veterans Affairs, Transportation, Defense, Homeland Security and the National Science Foundation. We specialize in applying technology, creativity and human-centered services to optimize mission delivery and improve experiences for millions of people who count on government services every day. Founded: 2012 Employees: 300+ nationwide EEO Statement Aptive is an equal opportunity employer. We consider all qualified applicants for employment without regard to race, color, national origin, religion, creed, sex, sexual orientation, gender identity, marital status, parental status, veteran status, age, disability, or any other protected class. Veterans, members of the Reserve and National Guard, and transitioning active-duty service members are highly encouraged to apply.