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Quality Improvement Specialist (HEDIS)

Axelon Services Corporation

Various, KY(remote)

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JOB DETAILS
SALARY
$21.80 Per Hour
SKILLS
Analysis Skills, Clinical Competency, Clinical Support, Communication Skills, Detail Oriented, Health Plan, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Providers, Healthcare Quality, Licensed Practical Nurse/Licensed Vocational Nurse, Medical Records, Medical Terminology, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft Word, National Committee for Quality Assurance (NCQA), Nursing, Performance Analysis, Performance Management, Presentation/Verbal Skills, Progress Reports, Quality Management, Trend Analysis, Vendor/Supplier Planning, Writing Skills
LOCATION
Various, KY
POSTED
2 days ago

Work Mode: 100% Remote - but must work 8am-5pm EST
Duration: 4 months

Responsibilities:

  • Support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations.
  • 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.

Requirements:

  • Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience.
  • Minimum 2 years of experience in medical record review and member outreach.
  • Experience in HEDIS or NCQA or related topics preferred.
  • Valid state clinical license preferred (i.e., LPN, RN, etc.).
  • Strong communication skills, can-do attitude, fast learner, positive attitude, experience reviewing medical records, attention to detail, tech savvy.

Preferred Skills:

  • Medical Record retrieval/validation, excellent verbal and written communication skills.
  • Proficiency in Microsoft Office – Excel, Outlook, Teams, Word, OneDrive.
  • Knowledge of Medical Terminology and tech-savvy abilities.

About the Company

A

Axelon Services Corporation