Job Description
Position Title: Quality Improvement Specialist (HEDIS)
Work Location: Remote – Arkansas
Assignment Duration: 3 Months
Work Schedule: 8–5 CST
Position Summary:
• Support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations.
• The position exists to support the health plans in the clinical aspect of medical record review.
Key Responsibilities:
• Train providers, health plans, and staff in methodologies and tools of continuous quality improvement and HEDIS abstraction and over-read processes.
• Provide clinical support to the medical record abstraction, over-read, and audit processes.
• Monitor performance on established contractual quality indicators.
• Analyze, track, and trend results.
• Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders.
• Recommend, develop, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model.
• Monitor and report PIPs progress through closure.
• Perform other duties as assigned.
• Comply with all policies and standards.
Qualification & Experience:
• Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience.
• Valid state clinical license preferred (LPN, RN, etc.).
• Experience in HEDIS or NCQA or related topics preferred.
Background & Context:
• Arkansas Quality Team needs staff to assist with End of Year Push projects to increase gap closure rates.
• This will include medical record retrieval and abstraction among other quality interventions.
- For information on benefits, equal opportunity employment, and location-specific applicant notices, click here
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 19.00/hr.