Quality Improvement Specialist (HEDIS)

Immediate need for a talented Quality Improvement Specialist (HEDIS). This is a 03 Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25- 87053

Pay Range: $17 - $18/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:

• Train providers, health plans and staff in methodologies and tools of continuous quality improvement and HEDIS abstraction and over-read processes
• Provide clinical support to the medical record abstraction, over-read and audit processes
• Monitor performance on established contractual quality indicators.
• Analyze, track and trend results
• Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders
• Recommend, develop, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model.
• Monitor and report PIPs progress through closure.
• Performs other duties as assigned
• Complies with all policies and standards

Key Requirements and Technology Experience:

• Skills-[“HEDIS”, “NCQA” , "HEDIS abstraction" , "HEDIS Retrieval" , "Quality Improvement"].
• Knowledge of NCQA technical specifications and how to navigate and utilize them
• Medical Terminology skills
• Technical skills, excel, word and Microsoft office suite
• Quality improvement, medical coding, data analytics, and compliance understanding
• Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience.
• Valid state clinical license preferred (i.e.- LPN, RN, etc.)
• Experience in HEDIS or NCQA or related topics preferred

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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