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Quality Performance Specialist

  • South Carolina, North Charleston

  • 09/17/2025

  • Contract

  • Active

Job Description:

  • Job Summary
    We are seeking a Quality Performance Specialist to support the Quality Department in achieving a minimum of 4.0 Stars for 2025. 
    The contractor will be responsible for managing key projects such as gift card fulfillment and member incentive notifications, aimed at encouraging members to close care gaps. 
    This role involves data handling, provider outreach, invoice processing, and potential member outreach.

    Key Responsibilities
    • Manage the gift card fulfillment project and member incentive notification process.
    • Pull, manipulate, and document data in spreadsheets for tracking and reporting.
    • Fax medical record requests to providers where EMR access is unavailable.
    • Process invoices for third-party copy services and maintain records on local drives.
    • Assist with HEAL system inquiries related to gift cards from Member Services.
    • Conduct outreach calls (minimum 20/day) to members who remain non-compliant with priority measures.
    • Document outreach activities in JIVA.
    • Support scripting for POM dialer and texting campaigns.
    • Perform high-level administrative duties with a focus on healthcare-related tasks.

    Required Qualifications
    • High School Diploma or equivalent.
    • Strong organizational, analytical, and interpersonal skills.
    • Excellent written and verbal communication abilities.
    • Ability to work effectively across all levels of the organization.
    • Proficient in PC applications including Word, Excel, and Adobe.
    • Healthcare experience and knowledge.
    • Ability to multitask, maintain attention to detail, and adapt to changing priorities.

    Preferred Qualifications
    • Experience in abstracting medical records (preferred but not required).

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