Senior Quality Operations Leader, Healthcare

JAVIER GUTIERREZ

Apollo Beach, FL ***** 813-***-**** *********@******.***

linkedin.com/in/javier370

PROFILE

Highly experienced International Medical Graduate with a proven track record in healthcare operations, training and development, clinical quality improvement, and population health management.

10+ years of experience optimizing healthcare processes, developing leadership and team capabilities through a servant leadership approach, driving innovation and leading change, and translating data into meaningful stories that guide strategic decisions-all with a strong focus on improving quality and achieving excellence in Star Measures. Extensive knowledge of Value-Based Care, Star Measures, HEDIS, Patient-Centered Medical Home (PCMH), and payer performance models.

Proven ability to manage ambiguity and uncertainty with a problem-solving aptitude and an strong leadership skills with a Servant Leadership philosophy, fostering engagement and high- performance cultures.

EXPERIENCE

MANAGER, QUALITY OPERATIONS

WellMed & Optum March 2023 - Present

Led Quality Performance initiatives across multiple clinics throughout Florida and multiple payors, with a focus on Star Measures-driving measurable improvements in care gap closures and patient experience outcomes.

Developed and standardized workflows and documentation strategies that supported EMR transitions without compromising Star Ratings or quality targets. Led efforts to drive Risk Adjustment performance through proper clinical documentation and accurate capture of HCC diagnoses to reflect an appropriate RAF score. Conducted focused training and coaching for clinic staff and providers on HEDIS measures, care gap identification, and performance dashboards as needed to drive measurable improvements.

Partnered with analytics and IT to enhance real-time quality tracking tools, improving the ability to target interventions and support underperforming providers. Championed a data-informed, servant leadership style-fostering trust, ownership, and collaboration within care teams during periods of organizational change. CLINICAL QUALITY CONSULTANT

WellMed February 2017 - March 2023

Served as a subject matter expert and coach for Star Measures and HEDIS, helping providers understand quality metrics and integrate them into daily workflows. Collaborated across departments to identify and close clinical documentation and care delivery gaps that directly impacted quality scores.

Led performance analysis and improvement initiatives that supported clinic Star goals, including patient outreach strategies and wellness visit completion. Delivered consistent, personalized support to providers, enabling sustained compliance with quality standards and improvement in member outcomes. Helped develop and refine quality metric dashboards that informed leadership decisions and clinic-level planning.

DIRECTOR OF OPERATIONS

Florida Family Primary Care Centers September 2015 - February 2017 Directed operations for departments including Healthcare Economics, Risk Adjustment, and Care Management, ensuring alignment with organizational strategy and payer performance expectations.

Led cross-functional initiatives that supported quality improvement, revenue integrity, and cost efficiency through improved coordination and reporting practices. Oversaw implementation and compliance with Patient-Centered Medical Home (PCMH) standards and supported Star Measures reporting across locations. Collaborated closely with the medical billing team to ensure accurate, timely claims and encounter submissions aligned with risk adjustment objectives. Analyzed clinic financial performance and quality metrics to drive strategic planning and improve both operational outcomes and patient care.

EDUCATION

Capella University – Master Public Health, 2027

Universidad de los Andes, Venezuela. – Medical Doctor (MD), 2009

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