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Quality Improvement Specialist (HEDIS)
Spectraforce
US
Remote

3 hours ago

Job Description

Position Title: Quality Improvement Specialist (HEDIS)

Work Location: Remote – Kentucky

Assignment Duration: 6 months

Work Schedule: Standard 8-hour workday starting at 8:00 AM EST and ending between 4:30–5:00 PM EST, depending on 0.5–1-hour lunch break

Work Arrangement: Remote

Position Summary:
• Supporting Wellcare of KY Improvement department and the HEDIS Operations team.
• These positions join a team comprised of abstractors and over readers, with a primary goal of identifying services to close quality measure gaps.
• This assignment is to support the existing team in constructing and managing Q4 initiatives to improve performance and to carry out the annual HEDIS hybrid chart chase project.
• Regular communication and collaboration with permanent staff on a scheduled and ad-hoc basis will be required.
• Comfortability with outbound phone calls is required for this role.

Qualification & Experience:
Education/Certification:

  • Required: Bachelor’s Degree in Nursing, Healthcare, or Quality

  • Preferred: N/A
    Licensure:

  • Required: N/A

  • Preferred: RN, BSN, LPN
    Experience:

  • Must have: Experience with HEDIS programs or NCQA-related topics, Microsoft Excel proficiency

  • Nice to have: Experience with HEDIS medical record abstraction preferred

  • Disqualifiers: No Quality Improvement experience
    Performance Indicators: Average daily productivity metrics outlined for record requests sent, records processed for intake, abstractions completed, or other duties assigned – to mirror permanent staff.

Top 3 Must-Have Hard Skills (Stack Ranked):

  1. Microsoft Excel – Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas)

  2. Medical Record Abstraction (Quality HEDIS) – Beginner to Intermediate

  3. Database Management / Standardized Data Entry – Intermediate

     

    Candidate Requirements
    Education/Certification Required: Required: Bachelor’s Degree Nursing, Healthcare, Quality Preferred:N/A
    Licensure Required: N/A Preferred:RN, BSN, LPN
    Years of experience required:
    Must have: Experience with HEDIS programs or NCQA related topics, Microsoft Excel proficiency
    Nice to have: Experience with HEDIS medical record abstraction preferred
    Disqualifiers: No Quality Improvement experience
    Performance indicators: Average daily productivity metrics outlined for record requests sent, records processed for intake, abstractions completed, or other duties assigned – to mirror permanent staff.
     
     
    • Top 3 must-have hard skills stack-ranked by importance
    1 Microsoft Excel - Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas)
    2 Medical record abstraction (Quality HEDIS) – Beginner to Intermediate
    3 Database Management / Standardized Data Entry – Intermediate
 
Applicant Notices & Disclaimers
  • 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: $ 21.00/hr.

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