Quality Improvement Specialist (Non-Clinical)

Immediate need for a talented Quality Improvement Specialist (Non-Clinical). This is a 06+ Months Contract (possibility of extension) opportunity with long-term potential and is located in California(Remote). Please review the job description below and contact me ASAP if you are interested.
 
Job ID:25-72712
 
Pay Range: $18 - $19/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities:

• Team is responsible for Peer Review Committee as well as Adverse Action.
• Our team needs help with sorting data in excel, compiling case files via Adobe PDF, pulling data from PRIME, writing case summaries, etc.
• Team member would help other team members/case owners with compiling case PDFs, writing case summaries based on medical records, downloading and saving medical records from PRIME database, drafting letters to provider offices, and helping with data sorting and analysis in Excel.
• Heavy chart monitoring and auditing of medical records.
• Monitor the production of quality results reporting; analyze, track, and trend the reporting results and report them to management.
• Formulate and prepare ad-hoc and additional reporting requirements.
• Recommend, develop, and implement quality improvement plans with management.
• Train providers and staff in methodologies and tools of continuous quality improvement.
• Prepare for and participate in meetings with State agencies, providers, and stakeholders.
• Perform audits on to meet state and internal requirements.

Key Requirements and Technology Experience:

• Key Skills: Proficient in Microsoft office (Word, Excel, PowerPoint).
• With Excel-proficient with data analysis and spreadsheets.
• Experience with Adobe and data analysis experience and writing skills.
• Knowledge of health insurance companies and/or previous experience in health care.
• Proficient in Microsoft office (Word, Excel, PowerPoint).
• With Excel-proficient with data analysis and spreadsheets.
• Experience with Adobe and data analysis experience and writing skills.
• Knowledge of health insurance companies and/or previous experience in health care.
• Communication skills and the ability to pay attention to detail.
• Experience reviewing medical records is preferred.
• Expert in Adobe PDF.
• Proficient writing skills.
• Associate degree, or high school diploma/equivalent is required.

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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