Quality Improvement Specialist (HEDIS)

Position Title: Quality Improvement Specialist (HEDIS)

Work Location: Remote - Arkansas

Assignment Duration: 3 Months

Work Schedule: 8-5 CST

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.

* Perform other duties as assigned.

* Comply 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 (LPN, RN, etc.).

* Experience in HEDIS or NCQA or related topics preferred.

Background & Context:

* Arkansas Quality Team needs staff to assist with End of Year Push projects to increase gap closure rates.

* This will include medical record retrieval and abstraction among other quality interventions.