What are the responsibilities and job description for the Quality Specialist position at SouthernMED?
Description:
Job Summary
The Quality Specialist role is focused on identifying and addressing Healthcare Effectiveness Data and
Information Set (HEDIS) gaps-in-care, ensuring compliance with healthcare quality standards, and
supporting overall patient health outcomes.
Key Responsibilities
- Review and analyze patient records to identify HEDIS gaps-in-care.
- Ensure accurate and timely documentation of quality measures.
- Communicate with healthcare providers to obtain necessary medical records and documentation.
- Assist in data collection, validation, and reporting for HEDIS measures.
- Collaborate with the quality improvement team to support performance initiatives.
- Maintain compliance with regulatory and accreditation requirements.
- Participate in training sessions and stay updated on healthcare quality standards.
Qualifications
- High School diploma required
- Minimum of 1-3 years of experience
Skills and Abilities
- Experience in medical records review, data entry, or healthcare quality preferred.
- Basic knowledge of HEDIS measures and healthcare quality programs is desired.
- Strong attention to detail and analytical skills.
- Excellent communication and organizational skills.
- Proficiency in Microsoft Office Suite and electronic health records (EHR) systems.
- Ability to work both independently and collaboratively in a team environment.
Working Environment
- Office-based
- Collaborative, patient-focused environment
Physical Demands
- Ability to sit for extended periods while working on a computer or attending meetings.
- Occasional light lifting and carrying of materials (up to 15 lbs).
- Ability to work in a fast-paced, sometimes stressful environment.
