Job Details

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Job Title: Quality Performance Specialist
Location: Remote
Duration: 3+ Months
Schedule: Mon-Fri, 8:30 AM - 5:00 PM EST

Job Overview:

The Quality Performance Specialist plays a pivotalrole within the Quality Management team, supporting QI program initiatives, HEDIS, CAHPS, NCQA accreditation, and critical incident (CI) tracking. This role ensures compliance with State, Federal, and NCQA standards, while integrating quality improvement into cross-functional areas.

Key Responsibilities:

• Manage and analyze annual HEDIS results and integrate findings into departmental goals
• Facilitate development and execution of the QI Work Plan and Program Description
• Support NCQA accreditation and member/provider satisfaction survey analysis
• Lead and track Critical Incident (CI) investigations, escalations, and resolutions
• Develop data-driven recommendations for QAPI planning and risk mitigation
• Serve as internal consultant and liaison across departments for QI efforts

• Associate's degree or equivalent experience required; Bachelor's preferred
• 3+ years of experience in healthcare quality improvement and service delivery
• Managed healthcare experience and NCQA accreditation knowledge preferred
• Strong analytical, communication, and project implementation skills
• Proficiency with Windows-based PC applications