ProfessionalServices - Quality Improvement Specialist (Non Clinical)

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

Job ID:25-88848

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:
 

• 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
• Performs other duties as assigned
• Complies with all policies and standards

Key Requirements and Technology Experience:

• Skills-Quality Improvement/HEDIS, Medical records and Auditing
• Must have a background knowledge of HEDIS and Risk Adjustment.
• Be able to work independently, think outside the box and complete 40/50 Pends (outbound calls per day).
• Great customer service skills, have basic computer skills and are proficient with the following applications:
• Microsoft Office, PowerPoint, Microsoft Excel.
• This role requires outreach via phone, email, fax and US Mail to providers to obtain medical records for review.
• Will log in daily accessing company systems
• Completing Compliance and Department Trainings.
• Reading Company & Department Policies.
• Minimum High School Diploma/ GED

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.
 
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.

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