Quality Specialist

EPIC Health System

Posted on : 09-04-2025

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1 Vacancy

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Job Location

Southfield, MI - USA

Monthly Salary

Not Disclosed

Salary Not Disclosed

Vacancy

1 Vacancy

Posted on : 09-04-2025

Job Description

Quality Specialist

Job Description:

The ideal candidate for this role is compassionate flexible selfmotivated detail oriented and a constant learner.As a Quality Specialist you will be the subject matter expert for HEDIS/Gaps in Care measures. You will ensure maintenance of programs for patients in accordance with prescribed quality standards; conduct data collection reporting and monitoring for key performance measurement activities recognized by the NCQA.

Responsibilities:

Provides expertise in analysis of data related to supporting valuebased programs. Skills include accessing internal databases and tables as well as utilizing Excel skills.
Participates in meetings with vendors for the medical record collection process. Assists Manager with medical record vendor oversight.

Participates in projects to ensure the strategic directives of the stakeholders are executed and time sensitive deadlines met.

Collaborate with providers and internal departments on rate investigation and validation activities including maintaining all evidence documentation and changes.
Monitor evaluate and report on program status inclusive of scope schedule budget and alignment to program and strategic goals.

Direct corrective action as needed to maintain the viability of valuebased reimbursement Programs.
Provide training and education to staff related to the data available how to access it and what metrics might be of interest.

Qualifications:

Bachelors Degree in related field and two 2 years experience in the health industry. An equivalent combination of education and experience may be substituted to meet this requirement.

HEDIS/Gaps in Care Experience

Knowledge of payers and their requirements for each measure

Knowledge of Patient Centered Medical Homes and Accountable Care Organizations

Microsoft Office Skills

The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff departments and customers.

Benefits:

Tracking key performance indicators

We offer a competitive compensation and benefits package including:

BiWeekly Competitive Pay

Opportunities for professional and personal growth

Excellent Health Insurance through Blue Care Network with a VIP policy to provide you with affordable access to the best care.

Premium Dental and Vision coverage

Buy Up Option for Short and LongTerm Disability and Life & AD&D Insurance

401(k) investment opportunities

Generous Holiday Vacation and Personal time

Work/Life Balance

Employee Recognition and Assistance Programs

Required Experience:

Unclear Seniority

Employment Type

Full Time

Company Industry

Key Skills

Apply Now

About Company

EPIC Health System

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Quality Specialist

EPIC Health System

Job Description

Employment Type

Company Industry

Key Skills

About Company

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