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:

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  Required: Bachelor's Degree in Nursing, Healthcare, or Quality

  
  
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  Preferred: N/A
  
  * Licensure:

  
  
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  Required: N/A

  
  
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  Preferred: RN, BSN, LPN
  
  * Experience:

  
  
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  Must have: Experience with HEDIS programs or NCQA-related topics, Microsoft Excel proficiency

  
  
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  Nice to have: Experience with HEDIS medical record abstraction preferred

  
  
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  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/Certification	Required: Required: Bachelor's Degree Nursing, Healthcare, Quality	Preferred:N/A
   Licensure	Required: N/A	Preferred: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	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