[Hiring] HEDIS Performance Improvement Specialist @Ascension

Role Description

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).
• Assist in educating new staff and providers about the quality improvement (QI) systems and requirements.
• Oversee complex HEDIS project lifecycles, including:
  • Data analysis
  • Medical record abstraction
  • Chase logic
  • Performance Improvement Projects (PIPs) writing development, update, and data analysis
• HEDIS experience, including planning the whole HEDIS project from start to end and understanding the process of medical record review and abstraction.
• Analyze HEDIS data to develop interventions for gaps in care.
• Maintain deep working knowledge of:
  • URAC/NCQA standards
  • The Uniform Managed Care Contract
  • State-specific programs like Texas Health Steps and Alternative Payment Models

Qualifications

• Licensure / Certification / Registration:
  • Certification specializing in Lean Healthcare Management preferred.
  • Licensure required relevant to state in which work is performed.
  • Project Management Professional preferred.
  • Registered Nurse preferred.
• Education:
  • 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.

Requirements

• Bachelor's Degree in Nursing is a must-have.
• 2+ years of Registered Nurse (RN) experience.
• 2+ years of HEDIS experience.
• Experience with Performance Improvement Projects (PIP).
• Must reside in Texas.

Benefits

• Paid time off (PTO)
• Various health insurance options & wellness plans
• Retirement benefits including employer match plans
• Long-term & short-term disability
• Employee assistance programs (EAP)
• Parental leave & adoption assistance
• Tuition reimbursement
• Ways to give back to your community