Job Description
Position Title: Quality Improvement Specialist (HEDIS)
Work Location: Remote - United States but must work 8am-5pm EST
Assignment Duration: 4 months
Work Arrangement: Remote
Position Summary:
• This is a backfill position for a temporary employee. This employee will help with Risk projects, MCD VBP initiatives, and medical record retrieval.
• The purpose of our team is to drive care gap closure, and help support initiatives that provide better outcomes for our members.
Background & Context:
This role supports The Organization's Medicaid initiatives through HEDIS operations, Risk, and member outreach in a collaborative environment.
Key Responsibilities:
• Pulling charts out of EMR’s and conducting member outreach.
• Cross trained to help with different projects and initiatives including Risk projects that continue year round, as well as VBP measure initiatives for Medicaid.
• Download of around 50 charts per day on average.
• Communicate and ask questions when they arise.
• Support member outreach initiatives to improve MCD rates.
Qualification & Experience:
• Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) OR equivalent experience in related healthcare experience.
• 2+ medical record review & member outreach.
• Preferred: LPN or RN.
• Strong communication skills, experience reviewing medical records, attention to detail, tech savvy.
• Microsoft Office – Excel (basic knowledge), Outlook, Teams, Word, OneDrive.
• Medical Terminology.
| Education/Certification | Required: Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) OR equivalent experience in related healthcare experience. | Preferred: Bachelor’s Degree | |||||||
| Licensure | Required: | Preferred: LPN or RN | |||||||
| Years of experience required: 2+ medical record review & member outreach
Disqualifiers: Supervisor positions/over qualified, position longevity (please state if contract AND IF COMPLETED),
Additional qualities to look for: Strong communication skills, Can-do attitude, fast learner, positive attitude, experience reviewing medical records, attention to detail, tech savvy, | |||||||||
| 1 | Medical Record retrieval/ validation, excellent verbal and written communication skills, | |||||||
| 2 | Microsoft Office – Excel (needs the basic excel knowledge), outlook, teams, word, one drive | ||||||||
| 3 | Medical Terminology, tech savvy | ||||||||
- 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 pay range is $18.00/hr - $20.00/hr.