Quality Specialist II - HEDIS NCQA Exp Required - Remote US

Magellan Federal (AFSC) is seeking a Quality Specialist II to support its quality team and maintain a strong quality program. The role coordinates quality and process improvement activities, conducts audits and data analyses, prepares reports, and supports accreditation and customer requirements.

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Responsibilities

• Serves as a member of the quality team at the national, regional or unit level. Coordinates projects resulting in continuous quality improvement and process improvement. Supports the maintenance of a strong quality program, measured processes including URAC, NCQA, and/or HEDIS (where applicable) and reported outcomes
• Coordinates assigned quality and process improvement activities which may include accreditation support, process improvement projects, quality studies, CQI (continuous quality improvement) process training for staff, prevention program coordination, care coordination initiatives, satisfaction survey coordination and follow-up, provider and member advisory groups (where applicable), tracking of adverse incidents, monitoring of performance guarantees, CAPs and customer related quality initiatives
• Conducts quality control reviews and external/internal audits
• Summarizes findings and prepares reports on findings
• Assists in the preparation of customer audits
• Conducts analyses of data findings for quality and process improvement and assists in report preparation for internal and external customers
• Leads and/or supports assigned quality committees and/or work groups through comprehensive project management, ensuring that documentation is accurate and timely, agenda items presented, and follow-up actions taken
• Supports the quality program with the goal to meet customer requirements and performance guarantees. Duties include monitoring and execution to meet timely deliverables
• Works independently and high degree of organization required

Preferred

• Bachelor's - Healthcare
• LSSGB - Lean Six Sigma Green Belt Certification - EnterpriseEnterprise
• LSSWB - Lean Six Sigma White Belt Certification - EnterpriseEnterprise
• Nonprofit job placement for military spouses, war wounded, caregivers.
• Fort Myers, Florida, USA
• https://militaryspousejobs.org
• Growth Stage
• Recent News
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• In-Person Career Support for Newport News Veterans and Families on August 5th
• 2026-07-16
• Offering Women Veterans with Employment Opportunities in VA's 'Boots on the Ground' Enrollment Efforts
• 2026-07-10
• Veteran Hiring: VetJobs Hosts June 10 Virtual Event with CACI
• 2026-06-08
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Qualifications

• 2+ years of HEDIS related experience (where applicable)
• 2+ years of quality improvement and auditing or related in healthcare field
• Attention to detail and ability to work efficiently to meet deadlines and timelines
• High degree of organization required
• Expertise in data management, data analysis, reporting word processing, and project management skills
• Strong working knowledge of Microsoft Excel, VISIO and MS Project
• Knowledgeable in HEDIS (where applicable) and Accreditation (NCQA and/or URAC) requirements
• Knowledge of healthcare quality improvement processes, accreditation standards, and HEDIS/performance measurement
• Strong working knowledge of Microsoft Excel, VISIO, and/or MS Project
• Excellent verbal and written skills and the ability to enter data accurately into spread sheets and prepare professional looking documents and reports
• High School/GED
• Bachelor's - Healthcare
• LSSGB - Lean Six Sigma Green Belt Certification - EnterpriseEnterprise
• LSSWB - Lean Six Sigma White Belt Certification - EnterpriseEnterprise
• 2+ years of HEDIS related experience (where applicable).
• 2+ years of quality improvement and auditing or related in healthcare field.

Required skills

• Data Analysis, Data Management, HEDIS, Healthcare Quality Improvement, Microsoft Excel, Microsoft Project, Microsoft Visio, NCQA Accreditation, Performance Measurement, Quality Auditing, URAC Accreditation

Preferred skills

• 2026-06-08, 2026-07-10, 2026-07-16, AI Tools, Analyze How Well You Fit, Bachelor's - Healthcare, Build Cover Letter, Company data provided by, Customize Your Resume, EIN Presswire, Fort Myers, Florida, USA, Growth Stage, Make your application stand out, Maximize your interview chances, Recent News, Understand your strength & weakness, https://militaryspousejobs.org

Experience

• 2+ years