Remote HEDIS Quality Improvement Specialist

Spectraforce Technologies, Inc.; Raleigh (NC); Remote; USD 70,000 - 100,000; Part time

Job summary

Spectraforce Technologies, Inc. is seeking a Quality Improvement Specialist (HEDIS) to support clinical record review for health plans. The role emphasizes NCQA/HEDIS measures, data analysis, and development of improvement plans using PDSA methodologies.

Remote work with nationwide project support; requires nursing/quality background and strong technical skills. Responsibilities include training providers, auditing records, tracking performance indicators, and collaborating with committees and

Qualifications

• BSN, healthcare, or quality background with HEDIS/NCQA knowledge.
• Experience with HEDIS/NCQA gap closure preferred.
• Knowledge of NCQA technical specifications.

Responsibilities

• Train providers and staff in QI methodologies and HEDIS processes.
• Provide clinical support for medical record abstraction and audits.
• Monitor quality indicators and track performance
• Prepare for meetings with committees and health plans
• Develop and implement PIPs using PDSA model

Skills

NCQA/HEDIS knowledge

Clinical quality improvement

Data analytics

Excel

Education

Bachelor's degree in Nursing/Healthcare/Quality

Tools

Excel

Word

MS Office Suite

Job description

Spectraforce Technologies, Inc. is seeking a Quality Improvement Specialist (HEDIS) to support clinical record review for health plans. The role emphasizes NCQA/HEDIS measures, data analysis, and development of improvement plans using PDSA methodologies.

Remote work with nationwide project support; requires nursing/quality background and strong technical skills. Responsibilities include training providers, auditing records, tracking performance indicators, and collaborating with committees and