Quality Improvement Specialist Jobs in New York
Quality Improvement Specialist jobs in New York are consistently active, with demand concentrated in healthcare systems, insurance, managed care, and government-affiliated agencies at levels from entry-level analyst through senior director. New York City, Albany, and Buffalo account for the largest share of openings, anchored by employers like NewYork-Presbyterian, Northwell Health, and Excellus BlueCross BlueShield. The most sought-after specialties in New York are healthcare quality and patient safety, regulatory compliance, and process improvement within Medicaid and Medicare programs. Find a role that fits below and apply directly.
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Showing 5 of 8+ Quality Improvement Specialist jobs
INTRODUCTION
VNS Health is seeking a Behavioral Health-focused Quality Improvement Specialist to lead initiatives that improve clinical quality, member outcomes, and provider performance across our Behavioral Health network and partnerships. This role is ideal for an experienced Licensed Clinical Social Worker (LCSW) or other licensed Behavioral Health professional with a passion for population health, behavioral health quality measures, provider collaboration, and healthcare transformation.
In this role, you will partner closely with vendor partners, providers, clinical teams, analytics, and network leadership to drive improvement in HEDIS/QARR measures, access to care, transitions of care, and overall member experience. You will use data insights, provider education, and quality improvement methodologies to support measurable improvements in behavioral health outcomes and regulatory performance.
The ideal candidate brings a strong understanding of Behavioral Health clinical practice, quality improvement, and health plan operations, along with experience engaging providers and implementing evidence-based interventions. This is an opportunity to influence system-wide Behavioral Health quality strategy while improving care for vulnerable populations.
WHAT WE PROVIDE
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
WHAT YOU WILL DO
- Conducts clinical assessment including and not limited to, medication reconciliations, post-discharge transitions of care assessment and follow-up post emergency department assessment
- Collaborates across departments to ensure compliance with DOH, CMS, and NCQA requirements. Coaches teams in applying continuous improvement methodologies (PDSA, LEAN, RCA) to achieve strategic objectives and national benchmarks for quality, satisfaction, and cost. Partners with analytics and program teams to identify trends and address performance gaps.
- Performs clinical reviews with network providers to validate diagnoses, address care gaps, and support accurate HEDIS/QARR documentation. Collaborates with providers to improve adherence to evidence-based care and quality measures.
- Leads and participates in multidisciplinary QI teams and committees to design, implement, and evaluate improvement initiatives related to clinical performance, documentation, and regulatory compliance. Supports development of annual QI work plan, program evaluation, and performance reporting. Supports value-based programs through data review, gap identification, and provider feedback.
- Performs medical record audits to evaluate adherence to documentation, coding, and quality standards. Provides education, feedback, and guidance to PCPs on VNS Health Medical Record Documentation Standards.
- Conducts audits of patient care records to monitor care quality and documentation accuracy. Develops forms, record abstracts, reports, and other tools used to implement concurrent and retrospective patient care review, including the design, testing and evaluation of the review methodology.
- Performs utilization and quality assessment reviews to maintain compliance with Federal and State regulatory requirements. Identifies & analyzes results to inform the development of correction plans.
- Collaborates with management to develop measurable action plans based on root-cause analysis, outcome trends, and survey results (HEDIS, CAHPS, Stars). Presents recommendations to QI committees and leadership to drive improvement and accountability.
- Participates in the preparation for and assists with site visits of external providers for the purpose of regulatory quality compliance.
- Develops and disseminates training materials, clinical guidelines, and quality protocols to promote consistent evidence-based care across provider networks and internal teams. Provides education sessions and quality coaching as needed.
- Conducts follow-up reviews and reassessments to ensure corrective actions for regulatory findings, complaints, or incidents are implemented effectively and sustained over time. Documents progress and escalates unresolved issues as appropriate.
- Develops, maintains, and updates QI policies and procedures aligned with evolving regulatory and industry standards. Collaborates with analytics to collect, interpret, and share performance data with internal teams to drive transparency and accountability.
- Participates in special projects and performs other duties as assigned.
QUALIFICATIONS
Licenses and Certifications:
- License and current registration to practice as a Registered Professional Nurse, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist in New York State or New Jersey required
Education:
Master's Degree Behavioral Health Only: Social Work or other Behavioral Health field required
Work Experience:
- Minimum of three years experience in a health plan or health care setting required
- Minimum of three years quality improvement experience preferred
- Minimum of one year experience, quality management, practice improvement and compliance preferred
- Demonstrated experience leading or facilitating cross-functional quality initiatives preferred
- Excellent oral, written and interpersonal communication skills, including group facilitation skills required
- Knowledge of basic Performance Improvement tools and methodologies (e.g., PDSA, LEAN, Six Sigma) preferred
PAY RANGE
USD $85,000.00 - USD $106,300.00 /Yr.
About us
VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
INTRODUCTION
VNS Health is seeking a Behavioral Health-focused Quality Improvement Specialist to lead initiatives that improve clinical quality, member outcomes, and provider performance across our Behavioral Health network and partnerships. This role is ideal for an experienced Licensed Clinical Social Worker (LCSW) or other licensed Behavioral Health professional with a passion for population health, behavioral health quality measures, provider collaboration, and healthcare transformation.
In this role, you will partner closely with vendor partners, providers, clinical teams, analytics, and network leadership to drive improvement in HEDIS/QARR measures, access to care, transitions of care, and overall member experience. You will use data insights, provider education, and quality improvement methodologies to support measurable improvements in behavioral health outcomes and regulatory performance.
The ideal candidate brings a strong understanding of Behavioral Health clinical practice, quality improvement, and health plan operations, along with experience engaging providers and implementing evidence-based interventions. This is an opportunity to influence system-wide Behavioral Health quality strategy while improving care for vulnerable populations.
WHAT WE PROVIDE
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
WHAT YOU WILL DO
- Conducts clinical assessment including and not limited to, medication reconciliations, post-discharge transitions of care assessment and follow-up post emergency department assessment
- Collaborates across departments to ensure compliance with DOH, CMS, and NCQA requirements. Coaches teams in applying continuous improvement methodologies (PDSA, LEAN, RCA) to achieve strategic objectives and national benchmarks for quality, satisfaction, and cost. Partners with analytics and program teams to identify trends and address performance gaps.
- Performs clinical reviews with network providers to validate diagnoses, address care gaps, and support accurate HEDIS/QARR documentation. Collaborates with providers to improve adherence to evidence-based care and quality measures.
- Leads and participates in multidisciplinary QI teams and committees to design, implement, and evaluate improvement initiatives related to clinical performance, documentation, and regulatory compliance. Supports development of annual QI work plan, program evaluation, and performance reporting. Supports value-based programs through data review, gap identification, and provider feedback.
- Performs medical record audits to evaluate adherence to documentation, coding, and quality standards. Provides education, feedback, and guidance to PCPs on VNS Health Medical Record Documentation Standards.
- Conducts audits of patient care records to monitor care quality and documentation accuracy. Develops forms, record abstracts, reports, and other tools used to implement concurrent and retrospective patient care review, including the design, testing and evaluation of the review methodology.
- Performs utilization and quality assessment reviews to maintain compliance with Federal and State regulatory requirements. Identifies & analyzes results to inform the development of correction plans.
- Collaborates with management to develop measurable action plans based on root-cause analysis, outcome trends, and survey results (HEDIS, CAHPS, Stars). Presents recommendations to QI committees and leadership to drive improvement and accountability.
- Participates in the preparation for and assists with site visits of external providers for the purpose of regulatory quality compliance.
- Develops and disseminates training materials, clinical guidelines, and quality protocols to promote consistent evidence-based care across provider networks and internal teams. Provides education sessions and quality coaching as needed.
- Conducts follow-up reviews and reassessments to ensure corrective actions for regulatory findings, complaints, or incidents are implemented effectively and sustained over time. Documents progress and escalates unresolved issues as appropriate.
- Develops, maintains, and updates QI policies and procedures aligned with evolving regulatory and industry standards. Collaborates with analytics to collect, interpret, and share performance data with internal teams to drive transparency and accountability.
- Participates in special projects and performs other duties as assigned.
QUALIFICATIONS
Licenses and Certifications:
- License and current registration to practice as a Registered Professional Nurse, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist in New York State or New Jersey required
Education:
Master's Degree Behavioral Health Only: Social Work or other Behavioral Health field required
Work Experience:
- Minimum of three years experience in a health plan or health care setting required
- Minimum of three years quality improvement experience preferred
- Minimum of one year experience, quality management, practice improvement and compliance preferred
- Demonstrated experience leading or facilitating cross-functional quality initiatives preferred
- Excellent oral, written and interpersonal communication skills, including group facilitation skills required
- Knowledge of basic Performance Improvement tools and methodologies (e.g., PDSA, LEAN, Six Sigma) preferred
PAY RANGE
USD $85,000.00 - USD $106,300.00 /Yr.
About us
VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
See All 8 Quality Improvement Specialist Jobs in New York
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Find JobsQuality Improvement Specialist Jobs by City in New York
Where New York roles are concentrated, by current openings.
Quality Improvement Specialist Job Market in New York
A snapshot from current New York openings, updated as new roles post.
Who's Hiring
- Island Peer Review Organization5
- VNS Health2
- Northwell Health1
Top Industries Hiring
- Science & Research6
- Healthcare & Medical Services3
What New York Employers Look For
The qualifications that appear most often in quality improvement specialist jobs across New York.
- Bachelor's degree in healthcare administration, public health, nursing, or a related field
- Certified Professional in Healthcare Quality (CPHQ) credential preferred or required
- Experience with HEDIS, NCQA, or Joint Commission accreditation standards in New York settings
- Proficiency in data analysis tools and quality management software such as Minitab or Excel
- Familiarity with New York State Department of Health regulations and reporting requirements
- Strong project management skills with experience leading cross-functional improvement initiatives
Quality Improvement Specialist Jobs in New York: Frequently Asked Questions
How do you become a quality improvement specialist in New York?
Most quality improvement specialist roles in New York require at minimum a bachelor's degree in a field like public health, healthcare administration, or nursing. There is no single state-issued license specific to the quality improvement specialty in New York, but many employers require or strongly prefer the Certified Professional in Healthcare Quality credential, administered by the National Association for Healthcare Quality. Candidates coming from clinical backgrounds often hold an active New York State professional license in their original field, which strengthens their application considerably.
Which companies hire quality improvement specialists in New York?
Employers hiring quality improvement specialists in New York right now include Island Peer Review Organization, VNS Health, and Northwell Health, based on current listings on Migrate Mate as of June 2026. New York's large integrated health systems, managed care organizations, and state-funded public health agencies generate particularly steady demand for this role across the calendar year.
Which New York cities have the most quality improvement specialist jobs?
Jericho, Albany, and Manhattan have the most quality improvement specialist openings in New York. New York City dominates by volume because of its concentration of major hospital systems, managed care insurers, and health department agencies, while Albany attracts openings tied to state government health programs and regulatory bodies, and Buffalo draws demand from large regional health systems and insurance carriers anchored in western New York.
Are there remote quality improvement specialist jobs in New York?
Yes, and more than many healthcare-adjacent roles, since quality improvement work is heavily data-driven and documentation-based rather than hands-on clinical. About 0% of quality improvement specialist openings tied to New York are remote or hybrid as of June 2026, reflecting real flexibility among managed care plans and consulting firms. Chart review, reporting, and policy development tasks are the functions most likely to be performed fully remotely.
How can I get hired as a quality improvement specialist in New York with little or no experience?
The most realistic entry path is moving laterally from a clinical or administrative role at a New York health system or insurer, where internal quality departments often hire from staff already familiar with their patient population and workflows. Large employers like Northwell Health and NYC Health and Hospitals post coordinator and analyst roles that accept candidates without dedicated quality experience. Completing a CPHQ review course or earning a Lean Six Sigma Green Belt certificate before applying gives early-career candidates a measurable edge in competitive New York markets.
Where can I find and apply to quality improvement specialist jobs in New York?
You can find and apply to quality improvement specialist jobs in New York on Migrate Mate, which lists current New York openings updated regularly. Search the available roles, find one that fits your background and location, and apply directly through the listing.
See All 8 Quality Improvement Specialist Jobs in New York
Find roles in New York that match your experience and apply in just a few clicks.
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