Quality Improvement Specialist
Job Detail
Remote (able to work in central time zone)
6 Months Contract
Education/Experience: Bachelor’s degree in related field or equivalent experience. Certified Professional in Healthcare Quality (CPHQ) preferred. 3 years of related experience.
License/Certification: Valid driver’s license. Certified Professional in Health Care Quality (CPHQ) preferred. • Heavy chart monitoring and auditing of medical records
• Monitor the production of quality results reporting; analyze, track and trend the reporting results and report them to management
• Formulate and prepare ad-hoc and additional reporting requirements
• Recommend, develop, and implement quality improvement plans with management
• Train providers and staff in methodologies and tools of continuous quality improvement
• Prepare for and participate in meetings with State agencies, providers, and stakeholders
• Perform audits on to meet state and internal requirements.
Must haves:
- Medical record retrieval experience via provider outreach
- HEDIS measure knowledge and experience
- Experience with Datavant/CIOX vendor portal (note CIOX changed names last year, so either name recognition suffices as vendor portal is the same).
- Experience with Datafied vendor portal (similar name as above, but indeed separate).
- EMR Datamining for HEDIS services
- Experience working on HEDIS Hybrid project
Significant time off needs between January and May
Performance indicators:
Medical record retrieval rate (Weekly targets)
Pends (or tasks) age
Production with medical record processing
Top 3 must-have hard skills:
- Experience in Quality Improvement and Provider telephonic outreach initiatives for Medical record retrieval
- HEDIS measure knowledge
- Experience with medical record/document management (processing, separating and re-naming PDFs)