Quality Improvement Specialist (HEDIS)
Spectraforce Technologies | ||||||||||||||||
United States, Ohio, Columbus | ||||||||||||||||
Dec 15, 2025 | ||||||||||||||||
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Position Title: Quality Improvement Specialist (HEDIS) Position Summary: 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
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Dec 15, 2025