Job Description

Position Title: Quality Improvement Specialist (HEDIS)

Work Location: Columbus, OH, 43219 Assignment Duration: 4 Months Work Schedule: Standard 8-hour workday 8am start (0.5-1hr lunch) Work Arrangement: Onsite 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.
• Performs other duties as assigned
• Complies 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 (i.e.- LPN, RN, etc.)
• Experience in HEDIS or NCQA or related topics preferred

Education/Certification Required: N/A Preferred: Bachelor's Degree Nursing, Healthcare, Quality Licensure Required: N/A Preferred: RN, BSN, LPN, etc. Years of experience required Disqualifiers Best vs. average Performance indicators Must have: Experience with HEDIS programs or NCQA related topics, Microsoft Excel proficiency Nice to have: Experience with HEDIS and/or medical records 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 Level of experience with each Stack-ranked by importance Candidate Review & Selection 1 Microsoft Excel - Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas) 2 Ability to use fax machine and document scanner 3 Attention to detail SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at [email protected] if you require reasonable accommodation.

Job Tags

Permanent employment, Local area,

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