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:
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Required: Bachelor’s Degree in Nursing, Healthcare, or Quality
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Preferred: N/A
• Licensure: -
Required: N/A
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Preferred: RN, BSN, LPN
• Experience: -
Must have: Experience with HEDIS programs or NCQA-related topics, Microsoft Excel proficiency
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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):
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Microsoft Excel – Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas)
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Medical Record Abstraction (Quality HEDIS) – Beginner to Intermediate
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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
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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.