Quality Improvement Specialist
100% Remote within the State of Texas only!
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 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 improve our hybrid measures. We are hiring contingent workers to support medical record retrieval during the MY2025 Project. We will work with a medical record retrieval vendor who will encounter barriers to retrieval during the season and will “pend” these chases to the health plan for resolution. The QI Specialist will resolve these “pends” and ensure we receive the records that contribute to member compliance and subsequently increase measure rates.
Responsibilities
Calling provider offices to request/validate facility and provider addresses, and/or collect medical records for the HEDIS project
Data entry of changes of addresses into the system
Uploading records upon receipt
Documenting all outreach efforts
Working with MS Excel
Heavy chart monitoring and auditing of medical records
HEDIS experience required
Monitor production of quality results reporting, analyze, track, and trend 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 to meet state and internal requirements
Perform other duties as assigned
Comply with all policies and standards
Position Purpose
Support the development and maintenance of quality improvement related projects and reporting. Respond to quality improvement inquiries.
Education & Experience
Bachelor’s degree in a related field or equivalent experience
Certified Professional in Healthcare Quality (CPHQ) preferred
3 years of related experience
Valid driver’s license
Certified Professional in Health Care Quality CPHQ preferred
Daily Schedule
8:00 – 17:00 (OT available as needed)
Pay and Benefits
The pay range for this position is $19.00–$21.00/hr. Eligibility requirements may apply. If eligible, benefits 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 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.
About TEKsystems
TEKsystems partners in transformation, helping clients activate ideas and solutions. We support a global workforce of 80,000 professionals working with over 6,000 clients.
Equal Opportunity Employer: 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 other characteristic protected by law.