HEDIS Performance Improvement Specialist
About The Position
Your future role at a glance Location: Remote - Must reside in Texas Facility: Ascension Care Management Insurance Department: Quality Management Schedule: Day Shift | Full Time | Monday-Friday Salary: $75,295.00 - $110,834.59 Eligible for an annual bonus incentive Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.
Requirements
- Knowledge of quality improvement principles, practices and procedures.
- High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
- Licensure required relevant to state in which work is performed
Nice To Haves
- Certification specializing in Lean Healthcare Mgmt preferred.
- Project Mgmt Professional preferred.
- Registered Nurse preferred.
- Bachelor's Degree in Nursing is a must-have.
- 2+ years of Registered Nurse (RN) experience
- 2+ years of HEDIS experience
- Performance Improvement Projects (PIP)
- Must reside in Texas
Responsibilities
- Plan, design, implement, and maintain a comprehensive program of continuous quality improvement (CQI).
- Assists in educating new staff, providers about the quality improvement (QI) systems and requirements.
- Oversees complex HEDIS project lifecycles—including data analysis, medical record abstraction, chase logic, thorough knowledge or Performance Improvement Projects (PIPs) and is able to apply that knowledge in PIP writing development, update, and analysis of data in PIPs.
- HEDIS experience, planning of the whole HEDIS project from start to end, how to complete the HEDIS Roadmap, understand the process and planning of medical record review and abstraction.
- Must be able to analyze HEDIS data to develop interventions for gaps in care.
- Maintains deep working knowledge of URAC/NCQA standards, the Uniform Managed Care Contract, and state-specific programs like Texas Health Steps and Alternative Payment Models.
Benefits
- Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options
- Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance
- Time to recharge: pro-rated paid time off (PTO) and holidays
- Career growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development and online learning
- Emotional well-being: Employee Assistance Program, counseling and peer support, spiritual care and stress management resources
- Family support: parental leave, adoption assistance and family benefits
- Other benefits: optional legal and pet insurance, transportation savings and more
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
