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Job Requirements of Quality Improvement Specialist (Non-Clinical):
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Employment Type:
Contractor
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Location:
Rockford, IL (Onsite)
Do you meet the requirements for this job?

Quality Improvement Specialist (Non-Clinical)
Pyramid Consulting, Inc
Rockford, IL (Onsite)
Contractor
Immediate need for a talented Quality Improvement Specialist (Non-Clinical). This is a 06 Months Contract opportunity with long-term potential and is located in U.S.(Remote-Eastern & Central Time Zone). Please review the job description below and contact me ASAP if you are interested.
Job ID:25- 89336
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:
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy . J2W:CB3
Job ID:25- 89336
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:
- Quality Improvement team members focused on the HEDIS Hybrid project. This role will be focused on medical record retrieval, vendor portal request management, provider outreach and document processing and management.
- Goal to retrieve medical records to improve HEDIS rates across all lines of business in the health plan (Medicare, MMP/Duals, Medicaid, Youthcare and Marketplace)
- Conduct outreach, track retrieval progress, research contact information, process incoming medical records. Meet individual goals and support team and organization goals.
- This position will be primarily telephonic outreach to provider offices, among other administrative tasks like PDF processing and navigating portals for daily tasks.
- Heavy chart monitoring and auditing of medical records
- Collaborate with team members to support efficient medical record retrieval
- Support the development and maintenance of quality improvement related projects and reporting. Respond to quality improvement inquiries.
- 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
- Skills-[“HEDIS”, “CPHQ” , "HEDIS abstraction" , "HEDIS Retrieval" , "Quality Improvement", "Medical Records" , "Medical Record Retrieval"].
- Medical record retrieval experience via provider outreach
- HEDIS measure knowledge and experience
- Experience with Datavant/CIOX vendor portal
- Experience with Datafied vendor portal (similar name as above, but indeed separate)
- EMR Datamining for HEDIS services
- Experience working on HEDIS Hybrid project
- Bachelor’s degree in related field or equivalent experience.
- Certified Professional in Healthcare Quality (CPHQ) preferred.
- 3 years of related experience.
- Valid driver’s license.
- Certified Professional in Health Care Quality (CPHQ) preferred.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy . J2W:CB3
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