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How much do hedis rn jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for hedis rn in Colorado is $36.15, according to ZipRecruiter salary data. Most workers in this role earn between $30.58 and $40.43 per hour, depending on experience, location, and employer.

What are HEDIS RNs?

HEDIS RNs, or Healthcare Effectiveness Data and Information Set Registered Nurses, are specialized nurses who review medical records to ensure healthcare organizations are meeting quality measures set by HEDIS. They collect, analyze, and report data related to patient care and outcomes, helping healthcare providers improve performance and comply with industry standards. HEDIS RNs play a critical role in quality assurance, working with both clinical teams and data analysts to ensure accurate reporting and better patient care.

What are some common challenges HEDIS RNs face during the annual reporting cycle?

HEDIS RNs often encounter challenges such as tight deadlines, managing large volumes of medical records, and ensuring data accuracy during the annual reporting cycle. Coordinating with various healthcare providers to obtain complete documentation can be time-consuming and sometimes requires persistent follow-up. Additionally, adapting to frequent updates in HEDIS measures and reporting requirements demands ongoing learning and flexibility. Despite these challenges, HEDIS RNs play a crucial role in improving healthcare quality by ensuring accurate and timely reporting.

How to make $300,000 a year as a nurse?

Hedis RNs can reach a high salary by gaining specialized certifications, such as case management or quality assurance, and working in high-demand settings like insurance companies or healthcare consulting. Increasing experience, taking on leadership roles, and working overtime or in management positions can also boost earnings toward $300,000 annually.

What does a HEDIS RN do?

A HEDIS RN reviews and analyzes healthcare data to ensure compliance with HEDIS (Healthcare Effectiveness Data and Information Set) measures, which assess the quality of care provided by health plans. They often collect, audit, and report data, requiring knowledge of clinical guidelines and data management tools to support quality improvement initiatives.

How to make $150,000 as a nurse?

Hedis RNs can reach a $150,000 salary by gaining specialized certifications, such as case management or informatics, working in high-demand settings like hospitals or insurance companies, and accumulating extensive experience. Advanced roles, overtime, and leadership positions also contribute to higher earnings in nursing.

How can I become a HEDIS nurse?

To become a HEDIS nurse, typically you need to be a registered nurse (RN) with a valid license and gain experience in case management, quality improvement, or healthcare analytics. Certification in HEDIS or healthcare quality measures can enhance your qualifications, and familiarity with electronic health records (EHR) systems is often required.

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

To thrive as a HEDIS RN, you need a solid background in nursing, strong clinical review skills, and familiarity with healthcare quality measures, typically supported by an RN license. Experience with HEDIS software, electronic health records (EHRs), and data abstraction tools is highly valuable. Attention to detail, analytical thinking, and effective communication enable you to accurately review patient records and collaborate with providers. These skills are crucial for ensuring accurate data collection, supporting quality improvement initiatives, and maintaining compliance with healthcare standards.

What is the difference between Hedis Rn vs Hedis Lpn?

AspectHedis RnHedis Lpn
CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentHospitals, clinics, insurance companiesLong-term care facilities, clinics, home health
Industry UsageHealthcare, insurance, quality assurance

Hedis Rn and Hedis Lpn both work in healthcare quality and compliance, focusing on HEDIS measures. RNs typically have more advanced training and perform more complex assessments, while LPNs handle routine data collection and support tasks. Both roles are essential in ensuring accurate HEDIS reporting, but RNs often have broader responsibilities and higher credential requirements.

What are popular job titles related to Hedis Rn jobs in Colorado? For Hedis Rn jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Hedis Rn jobs in Colorado look for? The top searched job categories for Hedis Rn jobs in Colorado are:
Hedis Rn jobs near you
Manager, HEDIS - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Manager, HEDIS - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Denver Health

Denver, CO • On-site

$31.25 - $41.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Denver Health rating

7.8

Company rating: 7.8 out of 10

Based on 66 frontline employees who took The Breakroom Quiz

177th of 999 rated hospitals

Job description

We are recruiting for a mission-driven Manager, HEDIS - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team!
We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.
Our Values
Respect | Belonging | Accountability | Transparency
Department
Managed Care Administration
* Must Live in Colorado
*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.
Job Summary
Under minimal supervision, the HEDIS manager will oversee the Health Employer Data Information Set (HEDIS), and HOS survey project timelines; collaborates with vendors and internal IT department to ensure all data requirements and submissions are accurate and timely. Supports Population Health and QI teams with metric data and strategy for MCR Stars, Medicaid MLR and NCQA certification. Promotes positive interpersonal (customer) relationships with fellow employees, physicians, patients and visitors. Supervises RN, Medical Records HEDIS personnel.
Essential Functions:
• Data Project Management: Oversees the HEDIS/ HOS data collection, development and analysis; maintains and updates appropriate data collection systems and enters information, as required, using MS Office, and Managed Care systems used to extract data for HEDIS/ HOS while driving and providing oversight of post-audit reviews to define operational improvements for future HEDIS cycles. Ensures compliance with all NCQA HEDIS Audit requirements. (15%)
  • Support strategic goals of MCR Stars by providing subject matter expertise on quality metrics and HEDIS strategy (15%)
  • Support NCQA accreditation process by providing subject matter expertise on quality standards (10%)
  • Work with providers on appropriate coding and documentation for HEDIS Stars and MLR measures. Oversee post-audit reviews to define operational improvements for future HEDIS cycles. (10%)
  • Process and Procedure: Determines work procedures and expedites workflow; assigns duties and reviews work; prepares necessary and required reports to management. Delegates responsibility/authority. Identifies problems and opportunities for improvement; identifies appropriate solution and involves others in the implementation process. Makes recommendations for cost efficiency and process improvement. Meets all NCQA HEDIS Medical Record Review (MRR) requirements and deadlines. (10%)
  • Reporting and Analysis Prepares and/or reviews daily, weekly, monthly and quarterly quality assessment reports and conducts/reports findings for QI data for all lines of business as required for HEDIS/ HOS activities, lead discussions about data/results, provides timely updates. Meets NCQA Compliance Audit activities to include annual training/testing of HEDIS staff and timely completion of Supplemental Data Audit (SD), Medical Record Review Validation (MRRV, Inter-Rater Reliability (IRR) tracking, and supports HEDIS annual roadmap submission. (10%)
  • Vendor Management: Partners with vendors and manages tracking progress during and prior to submission such as HEDIS auditor and Hedis Data vendor for medical record capture (10%)
  • Staff Management: Creates annual HEDIS training and testing materials per NCQA Technical Specification and compliance audit requirements. Identifies training and staff development needs of employees, recognizes positive behavior and contributions to the staff, using praise, appreciation and rewards, participates in the selection of QI staff, sets performance expectations by developing job specific customer service expectations and behaviors. Promotes guidance/oversight of certain tasks and delegates appropriately. (10%)
  • Oversee post-audit reviews to define operational improvements for future HEDIS cycles. (10%)

Education:
  • Bachelor's degree In nursing, health informatics, healthcare administration, public health or related field required

Work Experience:
  • 4-6 years Project Management experience, preferably in HEDIS/HOS within a managed care environment required and
  • 4-6 years previous experience in performing medical record review, inter rater reliability and working knowledge of medical terminology and NCQA HEDIS Technical Specifications required and
  • 4-6 years previous experience with HEDIS quality measurements for health plan STAR ratings and
  • 4-6 years previous experience in healthcare, quality improvement, statistics and/or evaluation.

Licenses:
Knowledge, Skills and Abilities:
  • Prerequisite skills including collecting, compiling and interpreting HEDIS CAHPS , and HOS data for QI studies
  • Extensive knowledge of MCR Stars program and NCQA accreditation process including previous experience with HEDIS quality measurements, health plan STAR ratings and quality reporting
  • Knowledge/familiarity with medical terminology, medical record review, NCQA HEDIS Technical specifications, and decision making skills regarding appropriateness of care review.
  • Provide HEDIS /HOS data for research design planning and analysis to generate quality improvement reports.
  • Applies efficient research and data collection skills and organize information by line of business succinctly
  • Ability to work independently as well as collaboratively with other internal and external team members to ensure timelines are met
  • Utilizes software applications and information systems to perform work processes with responsibility for training on such and providing updates as necessary
  • Demonstrated leadership skills in working with clinical professionals and office staff
  • Ability to coach and lead others on a collaborative basis to ensure team success
  • Ability to engage physicians, advance care providers, vendors, clinical leaders, and other key stakeholders to deliver member-centered care.
  • Demonstrate flexibility in response to unexpected changes.

* Must Live in Colorado
*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.
Shift
Days (United States of America)
Work Type
Regular
Salary
$98,600.00 - $152,800.00 / yr
Benefits
At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future - with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development - while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you're joining a mission-driven organization that invests in you.
Here is a small list of our benefit programs:
  • Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
  • 100% paid parental leave up to 6 weeks
  • Immediate eligibility for retirement plans with employer contribution up to 9.5%
  • Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
  • Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
  • Free RTD EcoPass (public transportation)
  • Childcare discount programs & exclusive perks on large brands, travel, and more
  • Tuition reimbursement & assistance
  • Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
  • Professional clinical advancement program & shared governance
  • Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
  • National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.
As Colorado's primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.

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