Sentara Quality Improvement Nurse Jobs (NOW HIRING)

At Duly Health and Care, you are supported to do your best work and make a meaningful impact every day. You will be part of a collaborative, physician-led team that works as one and puts patients at the center of everything we do. With a connected network of providers, care teams, and services across primary and specialty care, surgery centers, imaging, lab, and therapy, you are part of a system designed to deliver high-quality, coordinated care. Together, we create an environment where you can grow, contribute, and help improve the experience and outcomes for every patient we serve.

The Quality Improvement Nurse is responsible for driving measurable improvement in clinical quality metrics, Stars/HEDIS performance, and care gap closure aligned with payer quality incentives. This role supports population-level performance improvement with direct impact on quality revenue and value-based contract outcomes. The Quality Improvement Nurse works collaboratively with providers, clinic staff, and operational leadership to identify care gaps, improve medication adherence, and implement performance-driven quality initiatives.

This role carries a high level of accountability for achieving defined quality targets, optimizing payer incentive performance, closing gaps, and demonstrating measurable outcomes. The Quality Improvement Nurse independently evaluates quality performance data, interprets payer incentive structures and measure weighting methodologies, identifies high-value improvement opportunities, and prioritizes initiatives that maximize both clinical outcomes and financial performance.

The Quality Improvement Nurse must possess strong analytical skills and advanced proficiency in Excel and data analysis to perform trend analysis, performance forecasting, incentive impact assessment, and initiative monitoring. This role requires the ability to independently develop, execute, and adjust targeted action plans to improve quality and incentive performance, while participating in shared decision-making with providers and leadership.

Responsibilities:

• Analyze payer, clinical, and operational data to identify quality gaps, performance trends, and high-impact patient populations based on clinical risk and payer incentive weighting.
• Interpret payer contracts, quality incentive methodologies, and measure specifications to independently design targeted plans of action and performance interventions.
• Utilize advanced Excel skills to perform trend analysis, forecasting, incentive impact modeling, and performance monitoring.
• Independently develop, implement, and adjust action plans to improve quality metrics, Stars/HEDIS performance, medication adherence, and care gap closure.
• Conduct proactive patient outreach to support care gap closure and medication adherence; accountable for closing the loop and documenting measurable outcomes.
• Educate patients on the clinical significance of preventive care, chronic disease monitoring, and the importance of closing HEDIS/Stars gaps to improve long-term outcomes.
• Assess clinical, behavioral, and social barriers to care gap closure; coordinate multidisciplinary solutions and ensure documented resolution of gaps.
• Identify systemic workflow barriers and lead implementation, evaluation, and refinement of clinic workflows to improve quality performance and reduce recurring gaps.
• Provide measure-specific education and training to providers, clinic staff, and office teams on documentation requirements, quality metrics, and incentive impact.
• Develop and deliver standardized training materials, including handouts and slide decks, to support provider engagement and performance improvement.
• Participate in shared decision-making with providers and leadership to align performance improvement strategies with organizational goals.
• Support multiple quality initiatives simultaneously, including medication adherence, care gap closure, and broader quality measure improvement.
• Maintain detailed and accurate documentation of outreach, interventions, performance impact, and outcomes.
• Act as a subject matter resource regarding quality measures, payer incentive structures, adherence strategies, and workflow best practices.
• Support the development and refinement of quality improvement procedures, policies, protocols, and reporting tools.
• Adapt quickly to frequent workflow updates, operational changes, and evolving quality program requirements.
• Support special projects and additional quality improvement initiatives as assigned.

Qualifications:

• Bachelor's in nursing, Preferred
• Active Registered Nurse (RN) license in good standing in the state of Illinois.

Experience Required:

• Minimum of 2+ years of experience as a Registered Nurse in primary care, care management, population health, quality improvement, or value-based care environment.
• Experience supporting HEDIS, Stars, or other clinical quality measures preferred.
• Experience interpreting payer incentive programs or performance methodologies preferred.
• Strong analytical skills with advanced proficiency in Microsoft Excel required.
• Experience managing multiple concurrent initiatives in a fast-paced, performance-driven environment.
• Demonstrated proactive, solutions-oriented, and accountable work mentality.

Minimum Knowledge, Skills, and Abilities (KSA):

• Advanced analytical and data interpretation skills.
• Ability to interpret payer incentive structures and quality measure weighting.
• Strong independent thinking and decision-making capability.
• Ability to develop and execute targeted performance improvement plans.
• Strong provider-facing communication and training skills.
• Performance-driven mindset with accountability for measurable outcomes.
• Adaptability in a rapidly changing environment.
• Strong collaboration skills with providers and leadership teams.
• Detail-oriented with strong organizational skills.
• Self-starter, resourceful, resilient, and action-oriented with proactive problem-solving mindset.

The compensation for this role includes a base pay range of $67K-$85K, with the actual pay determined by factors such as skills, experience, education, certifications, geographic location, and internal equity. Additional compensation may be available through shift differentials, bonuses, and other incentives. Base pay is only a portion of the total rewards package.