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Spectraforce Technologies

Quality Improvement Specialist (HEDIS) at Spectraforce Technologies

Spectraforce Technologies Louisville, Kentucky

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):

  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

    Candidate Requirements
    Education/CertificationRequired: Required: Bachelor's Degree Nursing, Healthcare, QualityPreferred:N/A
    LicensureRequired: N/APreferred: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
    1Microsoft Excel - Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas)
    2Medical record abstraction (Quality HEDIS) - Beginner to Intermediate
    3Database Management / Standardized Data Entry - Intermediate

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