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Quality Improvement Specialist (HEDIS)

Spectraforce Technologies

United States, Arkansas, Little Rock

Sep 26, 2025

Position Title: Quality Improvement Specialist (HEDIS)

Work Location: Remote - Arkansas

Assignment Duration: 3 Months

Work Schedule: 8-5 CST

Work Arrangement: Remote-Arkansas

Position Summary:

Support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations. The position exists to support the health plans in the clinical aspect of medical record review.

Background & Context:

Arkansas Quality Team needs staff to assist with End of Year Push projects to increase gap closure rates. This will include medical record retrieval and abstraction among other quality interventions.

Key Responsibilities:

Train providers, health plans and staff in methodologies and tools of continuous quality improvement and HEDIS abstraction and over-read processes
Provide clinical support to the medical record abstraction, over-read and audit processes
Monitor performance on established contractual quality indicators.
Analyze, track and trend results
Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders
Recommend, develop, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model.
Monitor and report PIPs progress through closure.
Performs other duties as assigned
Complies with all policies and standards

Qualification & Experience:

Bachelor's degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience.
Valid state clinical license preferred (i.e.- LPN, RN, etc.)
Experience in HEDIS or NCQA or related topics preferred
Must haves: NCQA experience with HEDIS gap closure.
Nice to haves: quality improvement, medical coding, data analytics, and compliance understanding
Performance indicators:
- Knowledge of NCQA technical specifications and how to navigate and utilize them
- Medical Terminology skills
- Technical skills, excel, word and Microsoft office suite

Candidate Requirements
Education/Certification	Required: Bachelor's degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience.	Preferred: Bachelor's Degree, etc.
Licensure	Required	Preferred: : i.e RN, BSN, LPN, etc.
Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: NCQA experience with HEDIS gap closure. Nice to haves: quality improvement, medical coding, data analytics, and compliance understanding Disqualifiers: Performance indicators:
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	Knowledge of NCQA technical specifications and how to navigate and utilize them
2	Medical Terminology skills
3	Technical skills, excel, word and Microsoft office suite