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Hedis Jobs (NOW HIRING)

Pacer Group

HEDIS Data Reviewer

Philadelphia, PA · On-site

HEDIS Data Reviewer Location: Philadelphia, PA 19113 (Hybrid) Duration: 3 Months Schedule: Standard 8 am -5:30 pm EST Summary: Under the direction of the Manager of Medical Record Review Operations ...

Integrated Resources INC

HEDIS LPN RN

New York, NY · On-site

$33 - $43.75/hr

HEDIS 2015 Record Collection- Temps to assist with record collection and data abstractions and/or over-reads. Location: Candidate will mostly be working onsite on 77 Water Street in NYC. Weekly team ...

Pacer Group

HEDIS Data Reviewer

Philadelphia, PA · On-site

$40 - $44/hr

HEDIS Data Reviewer Location: Philadelphia, PA 19113, USA Duration: 3 Months Schedule: Standard Summary: Under the direction of the Manager of Medical Record Review Operations, the HEDIS Data ...

Integrated Resources INC

HEDIS RN/LPN

Trenton, NJ · 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.

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 ...

Ascension

HEDIS Performance Improvement Specialist

Austin, TX · Remote

$30 - $39.75/hr

Oversees complex HEDIS project lifecycles-including data analysis, medical record abstraction, chase logic, thorough knowledge or Performance Improvement Projects (PIPs) and is able to apply that ...

Integrated Resources INC

HEDIS RN LPN

New York, NY

$33 - $43.75/hr

HEDIS 2015 Record Collection- Temps to assist with record collection and data abstractions and/or over-reads. Location: Candidate will mostly be working onsite on 77 Water Street in NYC. Weekly team ...

Integrated Resources INC

HEDIS RN/LPN

Jacksonville, FL · On-site

$28 - $37/hr

HEDIS Nurse Location: Jacksonville, FL Duration: 5+ Months This positon is responsible for the coordination, implementation, and monitoring of all Medicaid and Medicare (Stars) HEDIS member. This ...

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How much do hedis jobs pay per hour?

As of Jun 6, 2026, the average hourly pay for hedis 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 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 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.

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

To thrive as a HEDIS Abstractor, you need a background in healthcare, knowledge of HEDIS measures, and experience with medical record review, often supported by a degree in nursing or health information management. Familiarity with health information systems, EHRs, and specialized HEDIS reporting software is typically required. Strong attention to detail, analytical thinking, and effective communication are critical soft skills for accurately extracting and reporting healthcare data. These skills and qualifications are essential to ensure regulatory compliance, improve quality ratings, and support healthcare organizations in delivering effective patient care.

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.

How can I make 2000 a week working from home?

Hedis is a healthcare quality measure role that typically involves analyzing patient data and ensuring compliance with healthcare standards. To earn $2000 weekly, professionals often need extensive experience, specialized skills, and may work as independent consultants or in high-demand positions, sometimes requiring certifications or advanced knowledge of healthcare data systems. Income levels vary based on workload, expertise, and employment arrangements.
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Hedis jobs near you
Infographic showing various Hedis job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 96% Full Time, 2% Part Time, and 1% Contract. Highlights an 79% Physical, 2% Hybrid, and 19% Remote job distribution, with an average salary of $71,500 per year, or $34.4 per hour.
HEDIS Utilization Review Nurse

HEDIS Utilization Review Nurse

Central Florida Health Care, Inc.

Winter Haven, FL • On-site

$26.50 - $35/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

Central Florida Health Care rating

6.1

Company rating: 6.1 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Title: HEDIS Utilization Review Nurse
Reports to: Director of Managed Care
FLSA Status: Exempt
Personnel Supervised: None
POSITION SUMMARY:
The HEDIS Utilization Review Specialist is responsible for performing comprehensive reviews of medical records to collect data required for HEDIS reporting. This role supports quality improvement initiatives by identifying gaps in care, validating clinical documentation, and ensuring compliance with NCQA (National Committee for Quality Assurance) standards.
KEY RESPONSIBILITIES:
  • Review medical records and clinical data for HEDIS-specific measures.
  • Abstract and input accurate clinical data from electronic health records (EHRs) into reporting tools.
  • Identify and report documentation deficiencies or care gaps.
  • Collaborate with providers, coders, and clinical teams to ensure proper documentation and follow-up.
  • Assist in the coordination and execution of the annual HEDIS data collection cycle.
  • Maintain knowledge of current HEDIS specifications and regulatory updates.
  • Support audits and internal quality improvement initiatives related to clinical outcomes.
  • Ensure HIPAA compliance and confidentiality of patient information.

SKILLS:
  • Strong knowledge of HEDIS measures and NCQA guidelines.
  • Proficient in EHR systems and chart review processes.
  • Detail-oriented with strong analytical and organizational skills.
  • Excellent communication and collaboration abilities.

MINIMAL QUALIFICATIONS:
  • Education: RN, LPN, LVN.
  • Experience:
    • 2+ years of clinical experience in a healthcare setting.
    • Prior experience with HEDIS abstraction or utilization review strongly preferred.
  • License: Florida unrestricted license
  • BLS certification
  • Computer literacy

KNOWLEDGE AND SKILLS:
  1. Knowledge of current professional nursing theory, practice, and techniques
  2. Knowledge of current nursing practices in an outpatient primary care setting
  3. Knowledge of assessment of patient needs and services
  4. Knowledge of current professional nursing and pharmaceutical products, Universal Precautions, and emergency situations
  5. Knowledge of basic pathophysiology of diseases commonly managed in Family Medicine
  6. Knowledge of the application of nursing techniques (example: Triage, blood pressure monitoring, glucose monitoring, etc.)
  7. Knowledge of patient teaching and education (example: self-blood pressure monitoring, nutrition instruction, diabetes self-care instruction)
  8. Knowledge of general patient care and treatment procedures, equipment, rules, regulations, and ethics
  9. Knowledge of Utilization Review Accreditation Commission (URAC) Policies and Procedures
  10. Knowledge of processing and obtaining prior authorizations
  11. Knowledge of making observations of general physical condition and needs of patients and when to confer with a physician about the emotional or physical condition of a patient
  12. Knowledge of the principles of aseptic and sterile techniques and infection control techniques
  13. Knowledge of the techniques of administration of common medications, including immunizations, inoculations, and allergy injections using sterile technique, and knowledge of the side effects of these medications
  14. Knowledge of state and federal drug control laws, rules, and regulations
  15. Knowledge of emergency techniques and procedures
  16. Knowledge of common medical supplies and equipment
  17. Excellent interpersonal, communication and leadership skills
  18. Ability to demonstrate priority-setting and ability to work in a complex environment
  19. Ability to function with a high degree of independence and collaboration with other health care providers
  20. Commitment to service, quality, and departmental core values

RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following:
  1. Be familiar with CFHC's program philosophies, goals and objectives. Be cognizant of and comply with all CFHC's policies and procedures, as well as state and federal regulations.
  2. Be competent in performing the duties of a nurse.
  3. Understand the requirements of CFHC's Exposure Control Plan. Personally, utilize universal precautions when practicing in a clinical setting.
  4. Participate in staff outreach and off-site health care programs as requested by the DMC, ACMO, CMO, or CEO. Represent CFHC in the community.
  5. Report as needed to DMC and any pertinent information or situations that impact on patient care or CFHC liability.
  6. Attend and participate in mandatory CFHC meetings (Center Specific meetings, Corporate meetings, and other meetings as designated by the DMC, ACMO, CMO, or CEO).
  7. Demonstrate ability to work cooperatively with other members of the clinical team. Be supportive of coworkers.
  8. Maintain a neat and professional appearance at all times.
  9. Carry out any other activities deemed appropriate by the DMC, CMO, or CEO.

Primary Duties include, but are not limited to, the following:
  1. Assess, identify problems, plan goals, monitor and evaluate patient plans, and develop strategies that meet the patients immediate and long-term goals.
  2. Work closely with PCP to manage patient "care items" which could include; medication refills per protocol, lab triage, document management, management of durable medical equipment (i.e. Glucometer, test strips, lancets), prior authorizations of needed medications or other services.
  3. Use patient data to track and schedule follow up appointments.
  4. Provide proactive utilization management for patients with high risk needs.
  5. Assist patients in obtaining appropriate medications and medical supplies and equipment, including coordination of pharmaceutical patient assistance programs.
  6. Participate in quality improvement, quality assurance and innovation activities to ensure optimal level of care delivery.
  7. This position will ensure all HEDIS measures have been met for those assigned patients and all care gaps have been identified.
  8. Assist in the coordination of warm hand-offs or "transfer of trust" between care team, pharmacy or other support services during the office visit.
  9. Carry out other duties as assigned by the DMC.

The job description is not intended to be all-inclusive, and employees will also perform other reasonable related business duties as assigned by supervisor.
*This organization reserves the right to revise or change job duties and responsibilities as the need arises. This job description does not constitute a written or implied contract or employment. *
BENEFITS:
Competitive Salary
Federal Student Loan Forgiveness:
PSLF - 10-year commitment, 120 loan payments and at the end of the commitment, the remaining loan is forgiven
Excellent medical, dental, vision, and pharmacy benefits
Employer Paid Long-Term Disability Insurance
Employer Paid Life Insurance equivalent to 1x your annual salary
Voluntary Short-Term Disability, additional Life and Dependent Life Insurance are available
Malpractice Insurance
Paid Time Off (PTO) - 4.4 weeks per year pro-rated
Holidays (9.5 paid holidays per year)
Paid Birthday Holiday
CME Reimbursement
401k Retirement Plan after 1 year of service (w/matching contributions)
Staff productivity is recognized and rewarded
PHYSICAL REQUIREMENTS
  1. Requires 80% or more time spent sedentary.
  2. Independently mobile.
  3. Ability to lift weight equivalents that would be required with re positioning equipment and lifting supplies.
  4. Ability to adapt and function in varying environments of workload, patient acuity, work sites, and work shifts.

American with Disabilities Act (ADA) Statement: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.

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