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Hedis Coder Jobs (NOW HIRING)

Integrated Resources INC

RN HEDIS /LPN

Trenton, NJ

$30.25 - $40/hr

Trenton NJ Immediate interview Experience in HEDIS chart audits or medical records reviews LPN or Coder with HEDIS experience required. Position Comments: LPN Auditors for HEDIS Audit Season or ...

Astiva Health

Jr. Quality Improvement Coder

Orange, CA · On-site

Review and advise on appropriate documentation and coding for HEDIS and RAF reporting. * Prepare ... summary reporting of the coding review results as requested. * Participate in ongoing discussions ...

Astiva Health

Jr. Quality Improvement Coder

Orange, CA · On-site

$25 - $28/hr

Review and advise on appropriate documentation and coding for HEDIS and RAF reporting. * Prepare ... summary reporting of the coding review results as requested. * Participate in ongoing discussions ...

Healthcare Support Staffing

HEDIS Nurse

Mason, OH

$28.50 - $37.50/hr

Candidate will work with the HEDIS team to collect member records and conduct reviews of these ... 10 coding Strong understanding of medical terminology Strong computer skills and must know MS ...

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How much do hedis coder jobs pay per hour?

As of Jul 2, 2026, the average hourly pay for hedis coder in the United States is $27.49, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $34.62 per hour, depending on experience, location, and employer.

What does a typical day look like for a Hedis Coder?

A Hedis Coder typically spends their day reviewing patient medical records, abstracting relevant data, and accurately coding information to support HEDIS quality measures. You’ll collaborate closely with quality assurance teams, healthcare providers, and data analysts to ensure compliance and accurate reporting. Meeting deadlines during the annual HEDIS data collection season can be a challenge, requiring both speed and precision. This role often offers opportunities to expand into quality improvement or supervisory roles as you gain experience and demonstrate expertise. The work is usually done in a healthcare facility or remotely, with a heavy emphasis on independence and careful review of medical documentation.

What are the key skills and qualifications needed to thrive in the Hedis Coder position, and why are they important?

To thrive as a Hedis Coder, you need a thorough understanding of medical terminology, ICD-10 and CPT coding systems, and healthcare quality measurement, usually supported by experience in medical coding and sometimes a coding certification (such as CPC or CCS). Familiarity with HEDIS reporting tools, electronic health records (EHR) systems, and data abstraction software is crucial. Attention to detail, analytical thinking, and effective communication are important soft skills that help ensure data accuracy and collaborative workflow. These competencies are essential for accurately extracting and reporting healthcare data to improve care quality and meet regulatory standards.

What is a Hedis Coder job?

A HEDIS Coder is a healthcare professional responsible for reviewing and abstracting medical records to ensure compliance with the Healthcare Effectiveness Data and Information Set (HEDIS) measures. They analyze patient data, identify gaps in care, and help healthcare providers improve quality performance. HEDIS Coders work with electronic health records (EHRs) and collaborate with healthcare teams to ensure accurate reporting. Their role is crucial in enhancing patient outcomes and meeting regulatory requirements.

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Hedis Coder jobs near you
Infographic showing various Hedis Coder job openings in the United States as of June 2026, with employment types broken down into 93% Full Time, and 7% Temporary. Highlights an 72% In-person, 14% Hybrid, and 14% Remote job distribution, with an average salary of $57,182 per year, or $27.5 per hour.
HEDIS Performance Analytics Lead

HEDIS Performance Analytics Lead

Capital Blue Cross

Harrisburg, PA • On-site, Remote

$83K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 24 days ago

Capital Blue Cross rating

7.7

Company rating: 7.7 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

180th of 277 rated insurance

Job description

Position Description
Base pay is influenced by several factors including a candidate's qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it's why our employees consistently vote us one of the "Best Places to Work in PA."
This role is a senior level analyst responsible for powering all HEDIS improvement initiatives through advanced data analytics and insight generation. This role serves as the engine behind HEDIS strategy-owning the end-to-end analytical framework that identifies performance gaps, prioritizes opportunities, and quantifies the impact of interventions. This role requires a blend of deep Medicare/Stars HEDIS expertise, advanced analytics capability, and strong cross-functional leadership. The ideal candidate thrives in a fast-paced environment, uses data to influence decision-making, and consistently delivers measurable performance improvement.
Responsibilities and Qualifications
Advanced Analytics & Modeling
  • Lead the development of predictive models to identify members at risk of care gaps and prioritize outreach opportunities.
  • Perform advanced statistical analyses to uncover drivers of HEDIS performance variation.
  • Develop segmentation strategies (provider, population, geography) to target high-impact interventions.
  • Design forecasting models to project HEDIS performance and simulate intervention scenarios.

Insight Generation & Strategic Influence
  • Translate complex analytical findings into clear, actionable recommendations for executive and operational stakeholders.
  • Identify the highest-value opportunities for improvement based on impact, feasibility, and ROI.
  • Serve as the primary advisor on HEDIS performance trends, risks, and opportunities.

Performance Measurement & ROI Analytics
  • Establish frameworks to measure the effectiveness of HEDIS interventions and initiatives.
  • Conduct pre/post and longitudinal analyses to evaluate program impact.
  • Quantify financial and quality outcomes, including Stars impact, incentive revenue, and cost of care implications.

Data Infrastructure & Reporting
  • Design and oversee enterprise HEDIS performance dashboards and reporting tools.
  • Partner with Analytics and Reporting HEDIS Technical team to ensure data quality, integration, and accessibility.
  • Automate reporting and insight generation to enable real-time performance monitoring.

Cross-Functional Partnership
  • Collaborate with Clinical, Quality, Provider Engagement, and Operations teams to align analytics with business needs.
  • Enable stakeholders with data, tools, and insights to execute targeted improvement initiatives.
  • Present findings and recommendations to senior leadership with clarity and influence.

HEDIS Expertise & Measure Optimization
  • Maintain deep expertise in HEDIS specifications, including hybrid and administrative measures.
  • Identify opportunities to improve measure capture, coding accuracy, and documentation through analytics.
  • Support audit readiness through data validation and performance reconciliation.

Qualifications
Required:
  • 7-10+ years of experience in healthcare analytics, HEDIS, or quality performance improvement.
  • Advanced analytical skills, including experience with predictive modeling, statistical analysis, and large datasets.
  • Demonstrated ability to translate data into actionable insights that drive measurable outcomes.
  • Proficiency in data tools and programming languages (e.g., SQL, Python, R).
  • Experience with data visualization tools (e.g., Tableau, Power BI).

Preferred:
  • Master's degree in Data Science, Public Health, Biostatistics, Healthcare Analytics, or related field.
  • Experience with NCQA HEDIS measures and reporting processes.
  • Familiarity with Medicare Stars, Medicaid quality programs, and value-based care models.
  • Experience working with claims, EHR, and supplemental data sources.

About Us
We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.
And by doing your best, you'll help us live our mission of improving the health and well-being of our members and the communities in which they live.

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