Quality Assurance Specialist at Community Physicians – Rockford, Illinois

At Community Physicians, we are a dedicated, multi-specialty medical group focused on providing exceptional, relationship-based care to older adults in skilled nursing and post-acute settings. Our mission is to improve health outcomes, enhance care transitions, and preserve the dignity of every patient we serve.

Why You Should Join Us?

1. Purpose-Driven Work:
You will play a vital role in caring for medically complex older adults during their most vulnerable health transitions. Your expertise will directly impact patient outcomes, reduce hospital readmissions, and improve quality of life.

2. Collaborative and Supportive Environment:
We believe in the power of partnership. You’ll work closely with facility staff, families, and interdisciplinary teams to ensure seamless, compassionate, and coordinated care.

3. Clinical Excellence and Innovation:
We prioritize evidence-based practices and continuity of care, bringing clinical excellence to every bedside. Our model allows you to practice meaningful medicine while making a tangible difference in patients’ lives.

4. Professional Growth and Leadership:
As part of our team, you’ll have opportunities to lead, innovate, and contribute to the growth of geriatric care in our community. We invest in our providers’ development and support their journey toward excellence.

5. A Culture of Compassion and Respect:
We are committed to treating every patient with dignity, empathy, and respect—and we extend that same commitment to our team. Here, you’ll be part of a culture that values each member’s contribution and well-being.

Job Description: Quality Assurance Specialist

Position Summary

The Quality Assurance Specialist supports quality and compliance by monitoring

assessment and visit documentation for completeness and accuracy, coordinating

follow-up with assessment staff, and maintaining tracking tools to ensure required items

are completed in a timely manner.

Key Responsibilities

 Review the BCBS system to confirm required items are completed for each

scheduled member, including visits, HRA notes, claims assignments, checklists,

and back-up plans.

 Review the Aetna system to verify completion of visit documentation, InterRAI

assessments, and assigned tasks for each member.

 Identify missing or incomplete data and notify the Assessment Specialist of

outstanding items.

 Follow up on communications from Assessment Specialists to ensure all required

documentation and tasks are completed.

 Update spreadsheets and trackers to reflect completion status and ensure data

integrity.

 Additional duties as directed by the supervisor.

Qualifications

 High school diploma or equivalent; associate degree or higher preferred.

 1+ years of experience in healthcare administration, quality, care management

support, or a related role.

 Experience working in clinical documentation, EMR/health plan systems, or

similar data systems.

 Proficiency with Microsoft Excel (filters, sorting, basic formulas) and Microsoft

Office.

 Strong attention to detail and ability to manage multiple items with deadlines.

 Ability to interpret documentation requirements and apply them consistently.

 Clear written and verbal communication skills for follow-up and escalation.

 Organizational skills to track multiple members/items and maintain accurate

records.

 Analytical mindset to identify trends in missing documentation and recommend

process improvements.

 Professional discretion when handling protected health information (PHI).

Preferred Qualifications

 Knowledge of HIPAA and privacy/confidentiality practices.

 Prior experience in auditing, data validation, or quality improvement.

Work Environment

 Remote setting.

 Standard business hours.

Physical Requirements

 Prolonged periods of computer and keyboard use.

 Ability to review documents on-screen for extended periods.