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Hedis Review Nurse Jobs (NOW HIRING)

HEDIS Review Nurse

Chicago, IL ยท On-site +1

$31.25 - $41.25/hr

The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey. The review nurse is responsible for ...

HEDIS Reviewer / HEDIS Quality

TX ยท Remote

$34 - $35/hr

HEDIS Quality Audit/HEDIS Quality Nurse Coordinator Location: 100% Remote (USA) Work Schedule ... The ideal candidates will review medical records, interpret clinical data, and ensure accurate ...

HEDIS Reviewer

MI ยท Remote

$44 - $45/hr

Position: HEDIS Reviewer - Work From Home (Michigan Only) Location: Remote - Must reside in ... Review medical charts, copy supporting documentation, and enter all abstracts into designated ...

HEDIS Nurse

Latham, NY

$29.25 - $38.75/hr

HEDIS RN/LPN Location: Latham, NY Start Date: 11/30/2015 Daily Responsibilities: * Performs ... Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting

HEDIS Nurse

Shelton, CT ยท On-site

$30.25 - $40/hr

HEDIS RN/LPN Location: Shelton, CT Daily Responsibilities: * Performs provider/practitioner medical ... Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting

HEDIS Nurse

Baton Rouge, LA ยท On-site

$29 - $38.50/hr

Title: HEDIS RN/LPN Location: Baton Rouge, LA Daily Responsibilities: * Performs provider ... Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting

HEDIS Record Reviewer

Milwaukee, WI ยท On-site

$29.75 - $39.50/hr

Qualifications State of Wisconsin licensed RN Previous experience with HEDIS Medical Record Review & Abstraction experience highly preferred Previous experience with medical records/familiarity with ...

HEDIS NURSE

New York, NY ยท On-site

$33 - $43.75/hr

A Special Project Nurse/Medical Professional will be responsible for completing auditing and/or ... Responsibilities includes medical records reviews, data collection, chart abstractions, reporting ...

HEDIS Chart Retrieval Nurse

Pittsburgh, PA ยท Remote

$29.25 - $38.75/hr

HEDIS Chart Retrieval Nurse Position Overview The HEDIS Chart Retrieval Nurse supports the health ... You will coordinate record retrieval, review incoming records for completeness, upload ...

HEDIS Nurse

Jacksonville, FL ยท On-site

$28 - $37/hr

HEDIS preferred Medical Review Nurses: Quality review / disease management experience AAAHC, Joint Commission, or Magnet experience is helpful Proficient in Microsoft Word and Excel Excellent ...

HEDIS RN/LPN

Latham, NY

$29.25 - $38.75/hr

HEDIS RN/LPN Location: Latham, NY Daily Responsibilities: * Performs provider/practitioner medical ... Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting

HEDIS LVN Case Manager

Victorville, CA ยท On-site

$27.66 - $29.07/hr

HEDIS LVN Case Manager / HEDIS Specialist The HEDIS LVN Case Manager / HEDIS Specialist supports ... Review and work an average of 20-30 medical records or member cases per day, adjusting for ...

HEDIS RN/LPN

Trenton, NJ ยท On-site

$30.25 - $40/hr

Trenton, New Jersey LPN Auditors for HEDIS Audit Season or Certified Coders need for HEDIS 2016 Experience in HEDIS chart audits or medical records reviews LPN or Coder with HEDIS experience required.

HEDIS RN / LPN

Baton Rouge, LA ยท On-site

$29 - $38.50/hr

Performs provider/practitioner medical record reviews, abstraction and data entry for HEDIS and ... , LPN Current, unrestricted state license in applicable field Experience working with HEDIS ...

HEDIS RN/LPN

Jacksonville, FL ยท On-site

$28 - $37/hr

HEDIS Nurse Location: Jacksonville, FL Duration: 5+ Months This positon is responsible for the ... Responsibilities includes medical records reviews, data collection, chart abstractions, reporting ...

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Hedis Review Nurse information

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How much do hedis review nurse jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for hedis review nurse in the United States is $34.38, according to ZipRecruiter salary data. Most workers in this role earn between $29.09 and $38.46 per hour, depending on experience, location, and employer.

What is a HEDIS Review Nurse?

As a HEDIS review nurse, you check medical records for completeness and accuracy according to the Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. Your responsibilities are to measure and to evaluate the performance of medical facilities and the quality of care that patients receive according to HEDIS. Your job duties are to create HEDIS reports, including incorrect or missing documentation, and to submit them to insurance health plans, accreditation commissions, and other organizations. Data analysis, attention to detail, and communication skills are essential for these jobs. Qualifications for a career as a HEDIS review nurse include nursing credentials and training in HEDIS measures.

What are the key skills and qualifications needed to thrive as a HEDIS Review Nurse?

To thrive as a HEDIS Review Nurse, you need a valid RN or LPN license, strong clinical knowledge, and experience with medical record review and quality assurance. Familiarity with HEDIS measures, electronic medical record (EMR) systems, and healthcare data abstraction tools is essential. Attention to detail, analytical thinking, and effective communication are important soft skills for accurately capturing data and collaborating with providers. These skills ensure precise reporting, regulatory compliance, and improved healthcare quality outcomes.

What are some common challenges HEDIS Review Nurses face when collecting and validating medical record data?

HEDIS Review Nurses often encounter challenges such as incomplete or inconsistent medical records, varying documentation practices across providers, and tight deadlines for data submission. Navigating multiple electronic health records (EHR) systems and ensuring compliance with strict quality and privacy standards can also be complex. Successful HEDIS Review Nurses develop strong attention to detail, effective communication skills for collaborating with providers, and adaptability to evolving HEDIS measure requirements.

What is the difference between Hedis Review Nurse vs Utilization Review Nurse?

AspectHedis Review NurseUtilization Review Nurse
CertificationsRN license, HEDIS trainingRN license, Utilization Review certification
Work EnvironmentInsurance companies, healthcare plansHospitals, insurance companies, healthcare organizations
Job FocusHEDIS data collection and quality improvementAssessing medical necessity and approving care

Hedis Review Nurses primarily focus on evaluating healthcare quality data using HEDIS measures, while Utilization Review Nurses assess medical necessity for patient care. Both roles require RN licensure and related certifications, often working within insurance or healthcare organizations. The main difference lies in their specific responsibilities: Hedis Review Nurses concentrate on quality metrics, whereas Utilization Review Nurses focus on care authorization and utilization management.

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Infographic showing various Hedis Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $71,500 per year, or $34.4 per hour.

HEDIS Review Nurse

VIVA USA INC

Chicago, IL โ€ข On-site, Remote

$31.25 - $41.25/hr

Contractor

Posted 6 days ago


Job description

Remote
Review Nurse
SUMMARY DESCRIPTION:
The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey. The review nurse is responsible for reviewing and accurately performing comprehensive review of medical records to abstract relevant clinical data during HEDIS. HEDIS abstractions are completed in accordance with NCQA guidelines and technical specifications. Additional responsibilities include but not limited to folder and file management, annotating medical records and saving completed documents with correct naming conventions on a shared drive as well as data entry into QSHR.
ESSENTIAL FUNCTIONS:
Abstract medical records
Apply product/plan specific abstraction criteria/requirements during medical record review process
Maintain defined productivity volumes
Sustain accuracy rate of 95% during abstraction and data entry throughout the HEDIS survey
Perform quality reviews of abstracted medical records as assigned
Ensure open and honest communication with management/designee regarding development or assistance needed throughout project
Escalate work related challenges/issues to Senior Director or designee
Attend scheduled daily and ad-hoc meetings with HEDIS Project Manager, and /or Quality Management Specialist/ designee to discuss project status, open issues and productivity
Comply with HIPAA, PHI, patient confidentiality, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies
Other duties as assigned
JOB REQUIREMENTS:
Registered Nurse (RN)/ Licensed Practical Nurse (LPN) with unrestricted license
2 years' HEDIS abstraction/over-reading experience
Data entry proficiency
Working knowledge PDF, Word and Excel
Excellent written and communication skills
Database management
Preferred Skills:
Experience in Pediatrics, Cardiology, Endocrinology and/or Obstetrics
QSHR proficiency
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status