HEDIS Performance Improvement Specialist

Ascension•Austin, TX

1d•$75,295 - $110,835•Remote

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 per year Eligible for an annual bonus incentive How you'll make an impact in this role 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. Knowledge of quality improvement principles, practices and procedures. 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.

Requirements

Must reside in Texas
High School diploma equivalency with 2 years of cumulative experience OR Associate'sdegree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
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)

Nice To Haves

Certification specializing in Lean Healthcare Mgmt preferred.
Project Mgmt Professional preferred.
Registered Nurse preferred.

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.
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.