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Quality Improvement Specialist (HEDIS)

Quality Improvement Specialist (HEDIS)

Spectraforce TechnologiesLittle Rock, AR, United States
17 days ago
Job type
  • Full-time
Job description

Position Title : Quality Improvement Specialist (HEDIS)

Work Location : Remote - Arkansas

Assignment Duration : 3 Months

Work Schedule : 8-5 CST

Position Summary :

  • Support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations.
  • The position exists to support the health plans in the clinical aspect of medical record review.

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.
  • Perform other duties as assigned.
  • Comply with all policies and standards.
  • Qualification & Experience :

  • 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 (LPN, RN, etc.).
  • Experience in HEDIS or NCQA or related topics preferred.
  • Background & Context :

  • Arkansas Quality Team needs staff to assist with End of Year Push projects to increase gap closure rates.
  • This will include medical record retrieval and abstraction among other quality interventions.
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    Quality Improvement Specialist • Little Rock, AR, United States