$37.25 - $50/hr
In this role you will support the HEDIS program by assisting with medical record retrieval and ... 7. Remote for the most part, will have expectations to come in on as-needed basis Additional ...
New
$37.25 - $50/hr
In this role you will support the HEDIS program by assisting with medical record retrieval and ... 7. Remote for the most part, will have expectations to come in on as-needed basis Additional ...
New
$135K/yr
Nurse Practitioner Delaware | Remote | Full-Time This is a remote position. Join our client ... of STAR and HEDIS quality gaps * Help develop and refine care pathways, workflows, and best ...
New
$135K/yr
Nurse Practitioner Delaware | Remote | Full-Time This is a remote position. Join our client ... of STAR and HEDIS quality gaps * Help develop and refine care pathways, workflows, and best ...
New
$27.02 - $48.55/hr
... , LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A, or CBCS, + 3 years HEDIS ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
$27.02 - $48.55/hr
... , LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A, or CBCS, + 3 years HEDIS ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...
Baltimore, MD · Remote
The Quality Analyst supports HEDIS, Stars, regulatory, quality improvement, and population health ... Licenses/Certifications Preferred: * RN-BC - Certified General Nursing Practice. Experience: 3 ...
New
Baltimore, MD · Remote
The Quality Analyst supports HEDIS, Stars, regulatory, quality improvement, and population health ... Licenses/Certifications Preferred: * RN-BC - Certified General Nursing Practice. Experience: 3 ...
New
$27.02 - $48.55/hr
Provides education for HEDIS measures, appropriate medical record documentation and appropriate ... CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS. Pay Range ...
$27.02 - $48.55/hr
Provides education for HEDIS measures, appropriate medical record documentation and appropriate ... CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS. Pay Range ...
Remote with occasional travel to Downers Grove, IL The Quality Improvement Nurse is responsible for driving measurable improvement in clinical quality metrics, Stars/HEDIS performance, and care gap ...
Remote with occasional travel to Downers Grove, IL The Quality Improvement Nurse is responsible for driving measurable improvement in clinical quality metrics, Stars/HEDIS performance, and care gap ...
Corpus Christi, TX · On-site +1
$27.02 - $48.55/hr
Highly preferred licenses/certifications: LVN, RN, CPC, CPC-A, CRC, or CPHQ Position Purpose ... Provides education for HEDIS measures, appropriate medical record documentation and appropriate ...
Corpus Christi, TX · On-site +1
$27.02 - $48.55/hr
Highly preferred licenses/certifications: LVN, RN, CPC, CPC-A, CRC, or CPHQ Position Purpose ... Provides education for HEDIS measures, appropriate medical record documentation and appropriate ...
This role is also responsible for reviewing clinical documentation to support HEDIS, and to participate in the HEDIS medical record abstraction process. The Clinical Documentation Improvement Nurse ...
This role is also responsible for reviewing clinical documentation to support HEDIS, and to participate in the HEDIS medical record abstraction process. The Clinical Documentation Improvement Nurse ...
This role is also responsible for reviewing clinical documentation to support HEDIS, and to participate in the HEDIS medical record abstraction process. The Clinical Documentation Improvement Nurse ...
This role is also responsible for reviewing clinical documentation to support HEDIS, and to participate in the HEDIS medical record abstraction process. The Clinical Documentation Improvement Nurse ...
$27.02 - $48.55/hr
... N licensure highly preferred. Position Purpose: Establishes and fosters a healthy working ... Provides education for HEDIS measures, appropriate medical record documentation and appropriate ...
$27.02 - $48.55/hr
... N licensure highly preferred. Position Purpose: Establishes and fosters a healthy working ... Provides education for HEDIS measures, appropriate medical record documentation and appropriate ...
Jersey City, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Jersey City, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Middlesex, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Middlesex, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Burlington, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Burlington, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Middletown, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Middletown, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Cape May, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Cape May, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Asheville, NC · On-site +1
$27.02 - $48.55/hr
... N licensure highly preferred. Position Purpose: Establishes and fosters a healthy working ... Provides education for HEDIS measures, appropriate medical record documentation and appropriate ...
Asheville, NC · On-site +1
$27.02 - $48.55/hr
... N licensure highly preferred. Position Purpose: Establishes and fosters a healthy working ... Provides education for HEDIS measures, appropriate medical record documentation and appropriate ...
Warren, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Warren, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Union, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Union, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Somerset, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
Quick apply
Somerset, NJ · Remote
$45 - $60/hr
In this role, the nurse manages a complex caseload of members and provides both remote support and ... HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform ...
$20.19 - $22.71
2% of jobs
$22.71 - $25.22
3% of jobs
$25.22 - $27.73
3% of jobs
$29.15 is the 25th percentile. Wages below this are outliers.
$27.73 - $30.24
29% of jobs
$30.24 - $32.76
6% of jobs
The median wage is $33.82 / hr.
$32.76 - $35.27
14% of jobs
$35.27 - $37.78
13% of jobs
$38.31 is the 75th percentile. Wages above this are outliers.
$37.78 - $40.30
19% of jobs
$40.30 - $42.81
5% of jobs
$42.81 - $45.32
3% of jobs
$45.32 - $47.84
1% of jobs
$20
$34
$47
A Remote HEDIS Nurse is a healthcare professional who reviews and evaluates medical records to ensure compliance with the Healthcare Effectiveness Data and Information Set (HEDIS) measures. They assess patient data, identify gaps in care, and work with healthcare providers to improve quality ratings. This role is typically seasonal and involves working from home using secure electronic health record (EHR) systems. Strong knowledge of HEDIS guidelines, medical coding, and data abstraction is essential. It helps healthcare organizations meet quality benchmarks and improve patient outcomes.
To thrive as a Remote Hedis Nurse, you need strong clinical assessment skills, a valid RN license, and experience with medical record review and quality initiatives. Familiarity with HEDIS reporting, electronic health records (EHR), and data abstraction tools is typically required. Exceptional attention to detail, independent work ethic, and effective written communication help nurses excel remotely. These abilities ensure accurate data collection and compliance with quality measures in a virtual healthcare environment.
Remote Hedis Nurses often face challenges such as ensuring data accuracy when reviewing diverse medical records and managing time effectively without direct in-person supervision. Staying organized, maintaining detailed records, and regularly communicating with team members or supervisors can help overcome these hurdles. It's important to be proactive in seeking clarification on documentation and to utilize available training resources for technical systems. By establishing a structured workflow and staying up-to-date on HEDIS guidelines, remote nurses can successfully meet performance expectations and contribute to high-quality healthcare reporting.
Cities with the most Remote Hedis Nurse job openings:
States with the most job openings for Remote Hedis Nurse jobs include:
The top searched job categories for Remote Hedis Nurse jobs are:
$37.25 - $50/hr
Full-time
Posted 3 days ago
New
MINIMUM QUALIFICATIONS:
EDUCATION, EXPERIENCE, CERTIFICATION, AND/OR LICENSURE:
1. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC) AND Four (4) years of healthcare clinical experience
OR
Bachelor's degree in healthcare or business-related field AND Six (6) years healthcare quality management or performance improvement in a health plan, hospital, or physician practice.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma; Currently enrolled in a BSN program and BSN completion within three (3) years of hire.
EXPERIENCE:
1. Managed Care knowledge or experience
2. Three (3) years Quality Management, Quality Improvement or Process Improvement Experience.
3. Knowledge of CMS guidelines, regulations, NCQA and HEDIS.
4. Thorough knowledge of Performance Improvement Projects (PIPs) and is able to apply that knowledge in PIP writing development, update, and analysis of data in PIPs.
5. Able to work with large data sets and analyze information and provide recommendations.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Plan, design, implement, and maintain a comprehensive program of continuous quality improvement (CQI) through HEDIS compliance rate tracking, trending and analysis as well as identifying existing challenges, inefficiencies and areas in need of improvement or intervention3. Assume accountability for HEDIS/Stars improvement activities including medical record review, chart collection, and member or provider interventions or education to improve HEDIS compliance rates for Medicare HEDIS/STARS measures.
4. Assist in preparing the annual QI evaluation report and plan/program documents.
5. Review medical records and other documentation to ensure quality care is being provided.
7. Ensure workflows, policies, procedures, regulatory and accreditation standards are implemented and maintain compliance for clinical programs.
8. Investigate potential quality of care issues that may affect the quality or safety of the health of members
9. Evaluate reports for continued compliance with clinical quality requirements.
10. Actively participate in quality committee, assist in developing annual work plans, program descriptions, and evaluations.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1.Standard office environment
SKILLS AND ABILITIES:
1. Demonstrated knowledge of CMS regulatory and contractual documents; knowledge of Medicare Advantage, URAC, and/or NCQA accreditation standards, including HEDIS/STARS.
2. Excellent written and oral communication
3. Problem solving capabilities to drive improved efficiencies and customer satisfaction
4. Attention to detail
5. Proficiency with Microsoft Office
6. Medicare experience preferred
7. Remote for the most part, will have expectations to come in on as-needed basis
Additional Job Description:
Scheduled Weekly Hours:
40Shift:
Exempt/Non-Exempt:
United States of America (Exempt)Company:
PHH Peak Health HoldingsCost Center:
405 PHH Quality Management
