Spectraforce Technologies
Quality Improvement Specialist (HEDIS)
Spectraforce Technologies, Columbus, Ohio, United States, 43224
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.
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-See Hard Skills
Microsoft Excel – Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas)
Ability to use fax machine and document scanner
Attention to detail
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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.
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-See Hard Skills
Microsoft Excel – Beginner to Intermediate (Sort, Filter, Format, Basic Visualizations, Simple Formulas)
Ability to use fax machine and document scanner
Attention to detail
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