Quality Improvement Specialist (HEDIS) - Remote

Quality Improvement Specialist

The HEDIS non-clinical team falls under the Quality Improvement Department of Superior HealthPlan in Texas. Most of our projects center on monitoring HEDIS rates all throughout the year, medical record retrieval, and reporting for our internal stakeholders in the healthplan. One of the biggest projects is the HEDIS Hybrid Project in the spring where we collect medical records across Texas to potentially create a lift for our hybrid measures. The reason for this request is to hire contingent workers that will support us in medical record retrieval during the MY2025 Project in Spring of 2006. We will be working with a medical record retrieval vendor who will encounter barriers to retrieval during season and will "pend" these chases to the healthplan for resolution. The QI Specialist will resolve these "pends" and ensure that we receive the records which will contribute to member's compliance and subsequently increase measure's rates.

Calling provider offices to request / validate facility and provider addresses, and / or collect medical records for the HEDIS project. Data entry of change of addresses into system. Uploading records upon receipt. Documenting all outreach efforts. Working with MS Excel.

This role is interesting because it is a key role in driving our overall healthplan ratings. It is a short project, but it is exciting and extremely important. The non-clinical team is a diverse group of individuals that are passionate about their work and are driven to be successful in the HEDI Hybrid project. They are very independent, but also very collaborative. They lead and assist the contingent workers during this busy season.

Position Purpose

Support the development and maintenance of quality improvement related projects and reporting. Respond to quality improvement inquiries.

Education / Experience

Bachelors degree in related field or equivalent experience. Certified Professional in Healthcare Quality CPHQ preferred. 3 years of related experience.

License / Certification

Valid drivers license. Certified Professional in Health Care Quality CPHQ preferred.

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.

Pay and Benefits

The pay range for this position is $19.00 - $21.00 / hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following :

• Medical, Dental & Vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off / Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline : This position is anticipated to close on Nov 13, 2025.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.