Quality Improvement Specialist (Non Clinical) – 520046
Remote in TX. Target Start Date: 5 January 2026. Assignment Duration: 3 months (end 04/30/2026). Possibility to extend or convert: Yes. Daily schedule: 8‑5 (OT available as needed).
Overview
The HEDIS non‑clinical team falls under the Quality Improvement Department of Superior HealthPlan in Texas. Projects center on monitoring HEDIS rates, medical record retrieval, and internal reporting. Key project: HEDIS Hybrid in the spring, collecting medical records across Texas to lift hybrid measures.
Project Focus
Support the contingent workforce during the MY2025 Project (Spring 2006). Work with a medical record retrieval vendor to resolve retrieval barriers. The QI Specialist will resolve “pends” and ensure receipt of records, contributing to member compliance and increasing 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 change 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.
Monitor production of quality results reporting, analyze, track, and trend results, and report 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 continuous quality improvement methodologies and tools.
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.
Qualifications
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.
HEDIS experience required.
Experience Level
Intermediate Level
Job Type & Location
Contract position based out of Austin, TX. Fully remote.
Pay & Benefits
Pay range: $19.00–$21.00 per hour.
Benefits (subject to eligibility and elections):
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre‑tax and Roth post‑tax contributions
Life Insurance (Voluntary Life & AD&DD 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)
Application Deadline
Position anticipated to close on 4 November 2025.
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 characteristic protected by law.