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Hedis Clinical Quality Jobs (NOW HIRING)

w3r Consulting

Quality Audit Specialist

Chicago, IL · On-site

This position supports the data collection of HEDIS clinical data set tied to technical ... Understanding of NCQA HEDIS quality measures and related code value sets. * Experience in HEDIS ...

VIVA USA INC

Quality Audit Specialist

Chicago, IL · On-site +1

This position supports the data collection of HEDIS clinical data set tied to technical ... Understanding of NCQA HEDIS quality measures and related code value sets. Experience in HEDIS value ...

Aviva Health

Clinical Quality Manager

Roseburg, OR · On-site

The Clinical Quality Manager collaborates with providers, other clinical departments and operations ... Oversight of external contractors such as HEDIS to move towards a value-based payment model

WorkPath Partners

Clinical Pharmacist

$42.26 - $45.78/hr

This position serves as internal and outward-facing, dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and ...

Grand Valley Medical Specialists, PLC

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Clinical Quality Manager

Grand Rapids, MI · On-site

... HEDIS, MIPS, Medicare Star Ratings, ACO, PCMH, PGIP and PIP requirements. · Coordinate quality ... clinical performance initiatives

Veteran-friendly

Urgent

Grand Valley Medical Specialists, PLC

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Clinical Quality Manager

Walker, MI · On-site

... HEDIS, MIPS, Medicare Star Ratings, ACO, PCMH, PGIP and PIP requirements. · Coordinate quality ... clinical performance initiatives

Grand Valley Medical Specialists, PLC

Be Seen First

Clinical Quality Manager

Walker, MI · On-site

... HEDIS, MIPS, Medicare Star Ratings, ACO, PCMH, PGIP and PIP requirements. · Coordinate quality ... clinical performance initiatives

Grand Valley Medical Specialists, PLC

Be Seen First

Clinical Quality Manager

Grand Rapids, MI · On-site

... HEDIS, MIPS, Medicare Star Ratings, ACO, PCMH, PGIP and PIP requirements. · Coordinate quality ... clinical performance initiatives

Veteran-friendly

Urgent

Pionear LLC

Clinical Pharmacist

$42.26 - $45.78/hr

This position serves as internal and outward-facing, dedicated clinical resource responsible for quality measures supporting the pharmacy department in identifying Star/HEDIS measure needs and ...

Village Care

RN Clinical Quality Manager

Manhattan, NY · On-site

$102K - $115K/yr

Position: RN Clinical Quality Manager Location: Hybrid (Must Reside in NY/NJ/CT) Work Schedule ... A Typical Workday Your day starts by reviewing dashboards and open items tied to HEDIS/Stars ...

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Hedis Clinical Quality information

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$42

$68

How much do hedis clinical quality jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for hedis clinical quality in the United States is $42.65, according to ZipRecruiter salary data. Most workers in this role earn between $35.10 and $46.88 per hour, depending on experience, location, and employer.

What is the difference between Hedis Clinical Quality vs Hedis Data Analyst?

AspectHedis Clinical QualityHedis Data Analyst
Required CredentialsHealthcare certifications, clinical quality trainingData analysis, healthcare or related certifications
Work EnvironmentHealthcare facilities, quality departmentsData teams, healthcare organizations
Employer & Industry UsageInsurance companies, healthcare providersHealthcare organizations, analytics firms

Hedis Clinical Quality focuses on improving healthcare quality metrics and compliance, often requiring clinical knowledge and certifications. Hedis Data Analysts analyze healthcare data to support quality initiatives but may not have clinical certifications. Both roles are vital in healthcare quality improvement but differ in their focus and skill sets.

What are some typical challenges faced by professionals in a HEDIS Clinical Quality role, and how can they be addressed?

Professionals in a HEDIS Clinical Quality role often encounter challenges such as managing large volumes of complex data, staying updated with changing HEDIS measures, and ensuring timely and accurate reporting. Navigating electronic health record (EHR) systems and coordinating with multiple departments can also be demanding. These challenges can be addressed by developing strong organizational skills, maintaining clear communication with clinical and IT teams, and participating in ongoing training to stay current on HEDIS requirements and best practices.

What are the key skills and qualifications needed to thrive as a HEDIS Clinical Quality professional, and why are they important?

To thrive as a HEDIS Clinical Quality professional, you need a solid understanding of healthcare quality measures, clinical data abstraction, and familiarity with HEDIS specifications, typically supported by a nursing or healthcare background. Proficiency in data analytics tools, electronic medical record (EMR) systems, and specialized HEDIS software is commonly required. Strong attention to detail, organizational skills, and effective communication set standout candidates apart in this role. These skills are vital for accurately measuring and improving healthcare quality metrics, ensuring compliance, and supporting better patient outcomes.

What is a HEDIS Clinical Quality professional?

A HEDIS Clinical Quality professional is responsible for managing and improving healthcare quality by ensuring compliance with HEDIS (Healthcare Effectiveness Data and Information Set) measures. These professionals collect, analyze, and report data related to patient care, working closely with healthcare providers to identify gaps in care and implement quality improvement initiatives. Their work helps health plans demonstrate the quality of care provided to members and meet regulatory or accreditation requirements. HEDIS Clinical Quality professionals often have backgrounds in nursing, healthcare administration, or data analysis.
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What cities are hiring for Hedis Clinical Quality jobs? Cities with the most Hedis Clinical Quality job openings:
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Hedis Clinical Quality jobs near you
Infographic showing various Hedis Clinical Quality job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 4% Contract, and 1% Nights. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $88,715 per year, or $42.7 per hour.

Clinical Quality Specialist

SIHO Insurance Services

Indianapolis, IN • On-site, Remote

$35 - $46.50/hr

Full-time

Re-posted 21 days ago

Job description

Job Title: Clinical Quality Specialist

Reports to: Director, Medical Management

The Clinical Quality Specialist supports the Clinical Quality Nurse in overseeing the HEDIS quality collection, submission, reporting, and auditing as well as assists with education to support the MyTruAdvantage line of business.

 

Key Responsibilities:

 

  • Knowledge of current HEDIS guidance, hybrid measure reporting, and measure compliance requirements.
  • Collaborate with Clinical Quality Nurse and internal data analyst to oversee HEDIS quality gap distribution to health partners and member providers for HEDIS clinical data collection.
  • Participate in communication with health partners regarding process of clinical document submission, annual education on applicable HEDIS measures, and cadence of reporting.
  • Help identify opportunities for improved or expanded HEDIS data collection.
  • Participate in internal chart chasing efforts.
  • Assure proper internal secure storage of HEDIS data collected from external providers.
  • Participate in Medical Record Review clinical submissions processes, assuring accuracy and completeness.
  • Support outreach efforts to external providers to collect clinicals needed for reporting.
  • Assist with maintaining all HEDIS related guidelines, policy & procedures, and auditing documents necessary for successful annual HEDIS audits.
  • Active participant in any external HEDIS audits performed as needed.
  • Support internal Chronic Care Improvement Program initiatives as needed.
  • Participate in internal or external process improvement efforts that support the quality improvement and collection efforts necessary for the Medicare Advantage or commercial lines of business. (Accurate provider attributions, training of health partners, training of new internal staff etc.)

Minimum Skills Requirement:

  • CMA or experience in clinical documentation review preferred.
  • Experience in working for or with HEDIS data collection and reporting preferred.
  • Proficiency in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint).
  • Experience with electronic medical records and using online tools.
  • Ability to communicate professionally with physicians and office staff to facilitate organizational initiatives.
  • Willingness to obtain applicable HEDIS certifications deemed appropriate for position.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.