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Hedis Jobs in Wisconsin (NOW HIRING)

Network Health, Inc

Pharmacist

Menasha, WI · On-site +1

The Pharmacist collaborates with other NHP departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider ...

Network Health, Inc

Pharmacist

Brookfield, WI · On-site +1

The Pharmacist collaborates with other NHP departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider ...

Network Health

Pharmacist

Menasha, WI · On-site +1

The Pharmacist collaborates with other NHP departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider ...

Network Health WI

Pharmacist

Menasha, WI · On-site

The Pharmacist collaborates with other NHP departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider ...

Mercyhealth

Credentialing Coordinator

Janesville, WI

Participates in HEDIS, as applicable to credentialing. * Manages delegated audits on an as-needed basis * Assists in the Medicaid re-certification process on an annual basis to ensure compliance as ...

Mercyhealth

Credentialing Coordinator

Janesville, WI · On-site

Participates in HEDIS, as applicable to credentialing. * Manages delegated audits on an as-needed basis * Assists in the Medicaid re-certification process on an annual basis to ensure compliance as ...

ChenMed LLC

Center Clinical Manager

Oregon, WI · On-site

$54.36 - $77.65/hr

Uses data analytics and dashboards to assist with the development and execution of business strategies that increase revenue and quality ratings (HEDIS/STARS/Clinical Gaps) and support our core model.

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Showing results 21-40

All JobsHedis JobsHedis Jobs in Wisconsin

Hedis information

See Wisconsin salary details

$20

$34

$48

How much do hedis jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for hedis in Wisconsin is $34.70, according to ZipRecruiter salary data. Most workers in this role earn between $29.38 and $38.80 per hour, depending on experience, location, and employer.

What are HEDIS jobs?

HEDIS jobs involve working with the Healthcare Effectiveness Data and Information Set (HEDIS), a widely used set of performance measures in the healthcare industry. Professionals in these roles typically collect, analyze, and report healthcare data to evaluate the quality of care provided by health plans. Common HEDIS job titles include HEDIS abstractor, HEDIS nurse, and HEDIS reviewer. These positions are crucial for ensuring health plans meet industry standards and regulatory requirements, and often require attention to detail and knowledge of medical records or coding.

What are HEDIS jobs?

Various jobs within the medical industry revolve around HEDIS. The most common career is to be a nurse with HEDIS certification. In this position, you use your knowledge of HEDIS to educate other staff members on the correct standards for healthcare procedures. Your responsibilities also include making proper documentation, coding for billing, and reporting on quality of care. There are also various levels of project and data analysts that handle the business side while still supporting the technical specifications for HEDIS. As an analyst, your duties are to oversee resources, methods, and reporting accuracy and look for areas for improvement within the department.

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

HEDIS professionals often encounter tight deadlines and the need to coordinate data collection from multiple sources within healthcare organizations during the annual reporting cycle. Ensuring data accuracy and completeness can be challenging, especially when working with electronic medical records and claims data that may have inconsistencies. Additionally, collaborating with clinical staff, IT teams, and quality improvement departments requires strong communication skills to resolve data gaps and implement process improvements. Staying current with evolving HEDIS measure specifications is also essential to ensure compliance and accurate reporting.

What is the difference between Hedis vs Medical Coder?

AspectHedisMedical Coder
Required CredentialsCertification in Hedis-specific guidelines, often a healthcare quality or coding certificationCertification in medical coding (e.g., CPC, CCS)
Work EnvironmentHealthcare facilities, insurance companies, or quality organizationsHospitals, clinics, or medical billing companies
Industry UsageUsed in healthcare quality measurement and complianceUsed in medical billing, coding, and documentation
Common Search/ComparisonHedis vs Medical Coder

Hedis professionals focus on healthcare quality measurement and compliance, utilizing specific guidelines and certifications. Medical coders primarily handle medical documentation coding for billing and records. While both roles are essential in healthcare, they serve different functions related to quality assurance versus billing processes.

How to become a Hedis abstractor?

To become a Hedis abstractor, candidates typically need a background in healthcare, medical coding, or health information management, along with strong attention to detail. Certification in medical coding or health data abstraction, such as the Certified Health Data Analyst (CHDA), can enhance job prospects. Familiarity with Hedis guidelines and data collection tools is also beneficial.

How to get into Hedis?

To pursue a career as a HEDIS specialist, candidates typically need a background in healthcare, nursing, or health information management, along with knowledge of quality measurement and data analysis. Relevant certifications, such as Certified HEDIS Professional (CHP), can enhance job prospects. Strong attention to detail and familiarity with electronic health records (EHR) systems are also beneficial.

What does a Hedis specialist do?

A Hedis specialist is responsible for reviewing and analyzing healthcare data related to the Healthcare Effectiveness Data and Information Set (HEDIS) measures to ensure compliance and improve quality scores. They often work with medical records, coding, and data management tools to accurately report patient care information and support healthcare quality improvement initiatives.
More about Hedis jobs

What are the most commonly searched types of Hedis jobs in Wisconsin?

The most popular types of Hedis jobs in Wisconsin are:

What are popular job titles related to Hedis jobs in Wisconsin?

For Hedis jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Hedis jobs in Wisconsin look for?

The top searched job categories for Hedis jobs in Wisconsin are:

What cities in Wisconsin are hiring for Hedis jobs?

Cities in Wisconsin with the most Hedis job openings:

Hedis jobs near you
Infographic showing various Hedis job openings in Wisconsin as of August 2026, with employment types broken down into 4% As Needed, 88% Full Time, 6% Part Time, and 2% Contract. Highlights an 74% Physical, 4% Hybrid, and 22% Remote job distribution, with an average salary of $72,169 per year, or $34.7 per hour.

Pharmacist

Network Health, Inc

Menasha, WI • On-site, Remote

Full-time

Posted 17 days ago

Network Health rating

7.9

Company rating: 7.9 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

187th of 315 rated insurance

Job description

The Pharmacist is responsible for providing clinical support for NHP's pharmacy, quality, compliance and health management efforts. This may include Case Management, Disease Management, Medication Therapy Management, Drug Utilization Review and creation of Clinical Programs to outcomes and cost effective drug therapy. This role assists in the development and evaluation of the plan formulary and benefit designs, and reports and presents such information as part of the NHP P&T Committee.  The Pharmacist collaborates with other NHP departments to optimize regulatory compliance and Quality Measures such as NCQA HEDIS. In addition, the Pharmacist assists in outreach efforts for provider education and provider detailing. 

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required) in combination with at our office in Brookfield or Menasha, in our hybrid workplace model.

Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday

Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

  • Assist with Commercial compliance workplan oversite
  • PBM follow up regarding claim audits (benefit change forms, member, reimbursement/ recoupments, follow up audits to monitor effectuation of changes)
  • Participate in case management, disease management and poly-pharmacy for NHP patients with extraordinary high drug costs, including related services
  • Assist in providing physician education in areas of potential improvement i.e., create articles for pharmacy newsletter for NHP providers, speak to medical departments regarding drug issues, speak to individual NHP providers regarding drug issues including those for individual NHP members, participate in appropriate quality improvement projects, etc.
  • Assist with Concurrent DUR,Retrospective DUR, and MTM programs
  • Assist with formulary management and identifying UM criteria
  • Performs other duties and responsibilities as assigned

Job Requirements:

  • Current Pharmacist licensure without restriction by the State of Wisconsin Pharmacy Examining Board required
  • Bachelor of Science in Pharmacy required, Doctor of Pharmacy preferred.
  • A minimum of 3 years clinical experience
  • Residency/fellowship preferred. Managed care experience desirable
  • Prefer experience in at least one of the following areas:
    • Medication Therapy Management Programs
    • Long Term Care Pharmacy consulting
    • Decentralized hospital pharmacy services

Network Health is an Equal Opportunity Employer

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