HEDIS Performance Improvement Specialist

Quality Management Role at Ascension Care Management Insurance

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 99,000+ 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.

Benefits That Help You Thrive

• 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

Benefit options and eligibility vary by position, scheduled hours and location. Benefits are subject to change at any time. Your recruiter will provide the most up-to-date details during the hiring process.

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 lifecyclesincluding 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.

What Minimum Requirements You'll Need

Licensure / Certification / Registration:

• Certification specializing in Lean Healthcare Mgmt preferred. Licensure required relevant to state in which work is performed
• Project Mgmt Professional preferred. Licensure required relevant to state in which work is performed
• Registered Nurse preferred. Licensure required relevant to state in which work is performed

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.

What Additional Preferences We're Seeking

• Bachelor's Degree in Nursing or a related health science degree is a must-have.
• 2+ years of Registered Nurse (RN) experience and 2+ years of HEDIS experience are preferred.
• Performance Improvement Projects (PIP)
• Must reside in Texas

Equal employment opportunity employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the poster or poster.

Fraud prevention notice

Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.

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