Job Profile Summary Position Purpose: 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. Education/Experience: Bachelor s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience. License/Certification: Valid state clinical license preferred (i.e.- LPN, RN, etc.) Experience: Experience in HEDIS or NCQA or related topics preferred

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 EEO: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans. Remote Skills: Analysis Skills, Clinical Competency, Clinical Support, Health Plan, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Providers, Healthcare Quality, Licensed Practical Nurse/Licensed Vocational Nurse, Medical Records, National Committee for Quality Assurance (NCQA), Nursing, Performance Analysis, Performance Management, Progress Reports, Quality Management, Trend Analysis, Vendor/Supplier Planning About the Company: Mindlance