Quality Improvement Specialist (HEDIS) at Spectraforce Technologies
Job Description
Position Title: Quality Improvement Specialist (HEDIS)
Work Location: Remote - Kentucky
Assignment Duration: 6 months
Work Schedule: Standard 8-hour workday starting at 8:00 AM EST and ending between 4:30-5:00 PM EST, depending on 0.5-1-hour lunch break
Work Arrangement: Remote
Position Summary:
* Supporting Wellcare of KY Improvement department and the HEDIS Operations team.
* These positions join a team comprised of abstractors and over readers, with a primary goal of identifying services to close quality measure gaps.
* This assignment is to support the existing team in constructing and managing Q4 initiatives to improve performance and to carry out the annual HEDIS hybrid chart chase project.
* Regular communication and collaboration with permanent staff on a scheduled and ad-hoc basis will be required.
* Comfortability with outbound phone calls is required for this role.
Qualification & Experience:
* Education/Certification:
Required: Bachelor's Degree in Nursing, Healthcare, or Quality
Preferred: N/A
* Licensure:Required: N/A
Preferred: RN, BSN, LPN
* Experience:Must have: Experience with HEDIS programs or NCQA-related topics, Microsoft Excel proficiency
Nice to have: Experience with HEDIS medical record abstraction preferred
Disqualifiers: No Quality Improvement experience
* Performance Indicators: Average daily productivity metrics outlined for record requests sent, records processed for intake, abstractions completed, or other duties assigned - to mirror permanent staff.
Top 3 Must-Have Hard Skills (Stack Ranked):
Microsoft Excel - Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas)
Medical Record Abstraction (Quality HEDIS) - Beginner to Intermediate
Database Management / Standardized Data Entry - Intermediate
Candidate Requirements Education/Certification Required: Required: Bachelor's Degree Nursing, Healthcare, Quality Preferred:N/A Licensure Required: N/A Preferred:RN, BSN, LPN Years of experience required:
Must have: Experience with HEDIS programs or NCQA related topics, Microsoft Excel proficiency
Nice to have: Experience with HEDIS medical record abstraction preferred
Disqualifiers: No Quality Improvement experience
Performance indicators: Average daily productivity metrics outlined for record requests sent, records processed for intake, abstractions completed, or other duties assigned - to mirror permanent staff.
- Top 3 must-have hard skills stack-ranked by importance
1 Microsoft Excel - Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas) 2 Medical record abstraction (Quality HEDIS) - Beginner to Intermediate 3 Database Management / Standardized Data Entry - Intermediate
Resume Suggestions
Highlight relevant experience and skills that match the job requirements to demonstrate your qualifications.
Quantify your achievements with specific metrics and results whenever possible to show impact.
Emphasize your proficiency in relevant technologies and tools mentioned in the job description.
Showcase your communication and collaboration skills through examples of successful projects and teamwork.