Quality Improvement Specialist

Immediate need for a Quality Improvement Specialist. This is a 04 Month Contract opportunity with long-term potential and is U.S(Remote). Please review the job description below and contact me ASAP if you are interested.
 
Job Diva ID: 26-00646
 
Pay Range: $18.00 - $19.00/hour (negotiable based on experience).  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:

• Work assigned quality “pends” to ensure timely resolution of outstanding documentation gaps
• Review and interpret pend codes and take appropriate action based on defined workflows
• Contact provider offices and medical groups to request missing medical records
• Create, send, and track medical record requests through internal systems
• Perform claims research to support audit completion and quality gap closure
• Accurately document outreach efforts and follow-ups
• Meet daily productivity and turnaround time expectations for assigned work
• Collaborate with team members and participate in scheduled meetings and training sessions

 
Key Requirements and Technology Experience: 

• Key skills; Experience with Medical Records
• Experience with HEDIS
• Experience with healthcare quality initiatives (HEDIS experience preferred)
• Medical record request and follow-up experience preferred
• Strong organizational and time management skills
• Proficiency with technology tools such as collaboration platforms, spreadsheets, and electronic medical records
• Prior quality improvement experience
• Previous auditing or compliance-related experience
• Knowledge of healthcare quality measures (especially hybrid measures)
• Ability to navigate multiple systems efficiently
• Strong communication skills for provider outreach
• Ability to work independently while meeting strict deadlines
• Complete assigned pend workload by the end of each business day
• Maintain accuracy, organization, and compliance with established quality standards
• Demonstrate reliability, time management, and attention to detail
• High School Diploma or GED

 
Our client is a leading Healthcare Insurance 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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