Job Summary

The Quality Specialist role is focused on identifying and addressing Healthcare Effectiveness Data and

Information Set (HEDIS) gaps-in-care, ensuring compliance with healthcare quality standards, and

supporting overall patient health outcomes.

Key Responsibilities

1. Review and analyze patient records to identify HEDIS gaps-in-care.
2. Ensure accurate and timely documentation of quality measures.
3. Communicate with healthcare providers to obtain necessary medical records and documentation.
4. Assist in data collection, validation, and reporting for HEDIS measures.
5. Collaborate with the quality improvement team to support performance initiatives.
6. Maintain compliance with regulatory and accreditation requirements.
7. Participate in training sessions and stay updated on healthcare quality standards.

Qualifications

1. High School diploma required
2. Minimum of 1-3 years of experience

Skills and Abilities

1. Experience in medical records review, data entry, or healthcare quality preferred.
2. Basic knowledge of HEDIS measures and healthcare quality programs is desired.
3. Strong attention to detail and analytical skills.
4. Excellent communication and organizational skills.
5. Proficiency in Microsoft Office Suite and electronic health records (EHR) systems.
6. Ability to work both independently and collaboratively in a team environment.

Working Environment

1. Office-based
2. Collaborative, patient-focused environment

Physical Demands

1. Ability to sit for extended periods while working on a computer or attending meetings.
2. Occasional light lifting and carrying of materials (up to 15 lbs).
3. Ability to work in a fast-paced, sometimes stressful environment.