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Managed Health Services (MHS) · 19 hours ago

Quality Improvement Specialist (HEDIS)

United States

Full-time

Remote

Mid Level

$56K/yr - $101K/yr

Managed Health Services (MHS) is a diversified national organization focused on transforming health in communities. The Quality Improvement Specialist (HEDIS) will support the development and maintenance of quality improvement projects related to HEDIS Hybrid Operations, providing clinical support and training to various stakeholders.

Health Care

Culture & Values

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

HEDISQuality ImprovementClinical SupportData AnalysisHealthcare ExperienceTraining SkillsCommunication SkillsTeam Collaboration

Required

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

Benefits

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible approach to work with remote, hybrid, field or office work schedules

Company

Managed Health Services (MHS)

Managed Health Services (MHS) is a managed care entity that has been proudly serving Hoosiers for more than two decades through the Hoosier Healthwise (HHW) and Hoosier Care Connect Medicaid programs and the Healthy Indiana (HIP) Medicaid alternative program.

Founded in 1994