Quality Improvement Specialist (HEDIS)

Position Title: Quality Improvement Specialist (HEDIS)
Work Location: Remote - United States but must work 8am-5pm EST
Assignment Duration: 4 months
Work Arrangement: Remote
 

Position Summary:
• This is a backfill position for a temporary employee. This employee will help with Risk projects, MCD VBP initiatives, and medical record retrieval.
• The purpose of our team is to drive care gap closure, and help support initiatives that provide better outcomes for our members.

Background & Context:
This role supports The Organization's Medicaid initiatives through HEDIS operations, Risk, and member outreach in a collaborative environment.

Key Responsibilities:
• Pulling charts out of EMR’s and conducting member outreach.
• Cross trained to help with different projects and initiatives including Risk projects that continue year round, as well as VBP measure initiatives for Medicaid.
• Download of around 50 charts per day on average.
• Communicate and ask questions when they arise.
• Support member outreach initiatives to improve MCD rates.

Qualification & Experience:
• Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) OR equivalent experience in related healthcare experience.
• 2+ medical record review & member outreach.
• Preferred: LPN or RN.
• Strong communication skills, experience reviewing medical records, attention to detail, tech savvy.
• Microsoft Office – Excel (basic knowledge), Outlook, Teams, Word, OneDrive.
• Medical Terminology.

Education/Certification	Required: Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) OR equivalent experience in related healthcare experience.						Preferred: Bachelor’s Degree
Licensure	Required:						Preferred: LPN or RN
Years of experience required: 2+ medical record review & member outreach    Disqualifiers: Supervisor positions/over qualified, position longevity (please state if contract AND IF COMPLETED),     Additional qualities to look for: Strong communication skills, Can-do attitude, fast learner, positive attitude, experience reviewing medical records, attention to detail, tech savvy,
Top 3 must-have hard skills stack-ranked by importance				1	Medical Record retrieval/ validation, excellent verbal and written communication skills,
				2	Microsoft Office – Excel (needs the basic excel knowledge), outlook, teams, word, one drive
				3	Medical Terminology, tech savvy

 

At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position's pay range is $18.00/hr – $20.00/hr.