Quality Improvement Specialist (Non-Clinical)

We are seeking a detail-oriented, punctual, and reliable Quality Improvement Specialist (Non-Clinical) to join a hard-working and collaborative team for the upcoming HEDIS Season (MY26) . In this role, you will be assigned to the "Pends" Team, working closely with both clinical and non-clinical staff to secure medical records and close critical care gaps. This is a dynamic contract opportunity where you will take ownership of daily pends status tracking, provider communication, and medical record request management within a supportive team environment. Position Type: Contract (Approximately 4 months) Pay Rate: $24.00 per hour Location: Remote (Candidates must reside in Arizona or Nevada ) Schedule: Monday – Friday, 8:00 AM – 5:00 PM AZ Time (1-hour lunch). Occasional overtime may be required when approved by management. Key Responsibilities Pend Management & Resolution: Actively work and resolve assigned pends in the provider portal system daily to secure required medical records and close care gaps. Pend Code Interpretation: Understand specific Pend codes and take swift, appropriate action based on internal guidelines. Provider Outreach: Contact provider offices and medical groups to request and obtain missing medical records necessary to complete the audit process. Record Tracking: Create, send, and diligently track medical record requests through completion. Claims Research: Perform accurate claims research to support pend resolution. Detailed Status Tracking: Maintain meticulously detailed logs of daily activities, progress, and pends status. Performance Expectations Daily Resolution: Individual team members are assigned a list of pends to work and resolve daily. Expectations are to successfully complete all assigned pends by the end of each business day. Qualifications & Skills Experience: At least 1 year of HEDIS experience preferred, OR 1 year of Pends / Medical Record Request experience preferred. Willing to train the right candidate who demonstrates strong foundational skills. Top Technical & Hard Skills: Knowledge of HEDIS Hybrid Measures. Proficiency across digital tools and platforms (Pends Portals, Smartsheet, Microsoft TEAMS, Excel, EMRs, and QMRM). Strong organizational skills with a proven track record of meeting daily deadlines. Soft Skills & Attributes: High attention to detail, strong work ethic, exceptional punctuality, and a collaborative mindset. #J-18808-Ljbffr Randstad USA