Remote HEDIS Quality Improvement Specialist

Randstad USA; Arizona; Remote; USD 27,000 - 39,000; Part time

Job summary

Randstad USA is seeking a detail-oriented Quality Improvement Specialist (Non-Clinical) for the HEDIS Season. This contract role focuses on pend management, medical records, and closing care gaps in a collaborative team.

You will handle daily pend status, provider outreach, and meticulous logging. Remote position with Arizona or Nevada residence required, 8:00 AM–5:00 PM AZ Time, Monday–Friday, with occasional overtime.

Qualifications

• At least 1 year of HEDIS experience preferred.
• 1 year of Pends / Medical Record Request experience preferred.
• Willing to train the right candidate who demonstrates strong foundational skills.

Responsibilities

• Pend Management & Resolution: Actively work and resolve assigned pends daily to secure records and close care gaps.
• Pend Code Interpretation: Understand pend codes and act per guidelines.
• Provider Outreach: Contact provider offices to request missing medical records.
• Record Tracking: Create, send, and track record requests through completion.
• Claims Research: Perform accurate claims research to support pend resolution.
• Detailed Status Tracking: Maintain detailed logs of daily activities and pend status.

Skills

HEDIS experience

Pends / Medical Records

Pend Codes

Provider outreach

Microsoft Excel

EMRs

Tools

Pends Portals

Smartsheet

Microsoft TEAMS

Excel

EMRs

QMRM

Job description

Randstad USA is seeking a detail-oriented Quality Improvement Specialist (Non-Clinical) for the HEDIS Season. This contract role focuses on pend management, medical records, and closing care gaps in a collaborative team.

You will handle daily pend status, provider outreach, and meticulous logging. Remote position with Arizona or Nevada residence required, 8:00 AM–5:00 PM AZ Time, Monday–Friday, with occasional overtime.