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Quality Improvement Specialist

100% Remote within the State of Texas only!

Description:

The HEDIS non-clinical team falls under the Quality Improvement Department of Superior HealthPlan in Texas. Most of our projects center on monitoring HEDIS rates all throughout the year, medical record retrieval, and reporting for our internal stakeholders in the health plan. One of the biggest projects is the HEDIS Hybrid project in the spring where we collect medical records across Texas to potentially create a lift for our hybrid measures. The reason for this request is to hire contingent workers that will support us in medical record retrieval during the MY2025 Project. We will be working with a medical record retrieval vendor who will encounter barriers to retrieval during season and will “pend” these chases to the health plan for resolution. The QI Specialist will resolve these “pends” and ensure that we receive the records which will contribute to member’s compliance and subsequently increase measure’s rates.

+ Calling provider offices to request/validate facility and provider addresses, and/or collect medical records for the HEDIS project

+ Data entry of change of addresses into system

+ Uploading records upon receipt

+ Documenting all outreach efforts

+ Working with MS Excel

Position Purpose:

Support the development and maintenance of quality improvement related projects and reporting. Respond to quality improvement inquiries.

Education/Experience:

+ Bachelors degree in related field or equivalent experience. Certified Professional in Healthcare Quality CPHQ preferred. 3 years of related experience.

+ License/Certification: Valid drivers license. Certified Professional in Health Care Quality CPHQ preferred.

+ Heavy chart monitoring and auditing of medical records

+ HEDIS Experience is required

+ Monitor the production of quality results reporting analyze track and trend the reporting results and report them to management

+ Formulate and prepare ad-hoc and additional reporting requirements

+ Recommend develop and implement quality improvement plans with management

+ Train providers and staff in methodologies and tools of continuous quality improvement

+ Prepare for and participate in meetings with State agencies providers and stakeholders

+ Perform audits on to meet state and internal requirements

+ Performs other duties as assigned

+ Complies with all policies and standards

Daily Schedule: 8-5 (OT available as needed)

Pay and Benefits

The pay range for this position is $19.00 - $21.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Nov 3, 2025.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.