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Remote Hedis Review Nurse Jobs (NOW HIRING)

Managed Staffing

HEDIS Reviewer / HEDIS Quality

TX · 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 ...

Managed Staffing

HEDIS Reviewer

MI · Remote

$44 - $45/hr

Remote - Must reside in Michigan (MI) Schedule: Monday - Friday, 8:00 AM - 5:00 PM Job Summary: HEDIS Reviewer III (Medical Record Review Abstractor) to support HEDIS quality reporting. This role ...

Healthcare Support Staffing

Remote HEDIS Specialist

OR · Remote

Assists the Manager in the coordination and preparation of the HEDIS medical record review which ... N/LVN/LPN HEDIS knowledge Ability to read and understand medical records Independent and able to ...

Sentara Healthcare

IT HEDIS & Analytics Manager

Norfolk, VA · On-site +1

$29.25 - $38.75/hr

Overview The IT HEDIS Manager is responsible for leading the technology, data integration, platform ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Sentara Health

IT HEDIS & Analytics Manager

Norfolk, VA · On-site +1

$10K/mo

Overview The IT HEDIS Manager is responsible for leading the technology, data integration, platform ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Astrana Health, Inc.

UM Review Nurse

Monterey Park, CA · On-site +1

$34 - $47/hr

UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Astrana Health, Inc.

UM Review Nurse

$34 - $47/hr

UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...

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How much do remote hedis review nurse jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for remote 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 are the key skills and qualifications needed to thrive as a Remote HEDIS Review Nurse?

A Remote HEDIS Review Nurse needs a valid RN license, clinical experience, and strong knowledge of HEDIS measures and medical record review processes. Familiarity with healthcare data systems, electronic medical records (EMRs), and HEDIS abstraction software is essential, along with understanding NCQA guidelines. Attention to detail, time management, and effective written communication skills help ensure accuracy and efficiency while working independently. These skills are crucial to accurately capturing quality data, supporting compliance, and improving healthcare outcomes in a remote environment.

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

AspectRemote Hedis Review NurseRemote Utilization Review Nurse
CertificationsRN license, HEDIS knowledgeRN license, Utilization Review certification
Work EnvironmentInsurance companies, healthcare plansHospitals, insurance companies, healthcare organizations
Job FocusHEDIS data collection and quality improvementAssessing medical necessity and resource utilization

Remote Hedis Review Nurses primarily focus on HEDIS data collection and quality metrics, while Remote Utilization Review Nurses evaluate medical necessity and resource use. Both roles require RN licensure, but the specific certifications and daily tasks differ, reflecting their distinct focus areas within healthcare quality and utilization management.

What is a Remote HEDIS Review Nurse?

Remote HEDIS Review Nurses are registered nurses who work from home to review medical records and evaluate healthcare providers' compliance with HEDIS (Healthcare Effectiveness Data and Information Set) measures. Their primary role is to collect, analyze, and validate clinical data to ensure quality standards are met for health plans and organizations. They collaborate with healthcare teams, use specialized software to track data, and help improve patient care outcomes. This position typically requires strong attention to detail, experience in clinical settings, and familiarity with HEDIS measures.

What are some common challenges faced by Remote HEDIS Review Nurses, and how can they be managed?

Remote Hedis Review Nurses often face challenges such as navigating multiple electronic health record (EHR) systems, maintaining data accuracy, and communicating effectively with offsite team members. Time management is crucial, as deadlines for HEDIS data abstraction and reporting can be tight. To manage these challenges, it's helpful to establish a dedicated, distraction-free workspace, stay organized with digital tools, and actively participate in team meetings and trainings to stay updated on quality measures and best practices.

What is the highest paid remote Hedis Review Nurse job?

The highest paid remote HEDIS Review Nurse positions typically offer salaries ranging from $80,000 to over $100,000 annually, depending on experience, certifications, and employer. Senior or specialized nurses with extensive HEDIS knowledge and strong clinical backgrounds tend to earn the top salaries in this field.

What does a Remote HEDIS Review Nurse do?

Healthcare Effectiveness Data and Information Set (HEDIS) is a system for assessing the quality of care and clinical performance. Your duties as a remote HEDIS review nurse are to assess medical records and clinical information to perform an analysis of a facility's quality of care. In this work from home job, you collect the data remotely and contact facilities and medical records departments on the phone when necessary. HEDIS has dozens of different parameters, so you assess the data to identify information that proves that the facility met those requirements. Your responsibilities include reporting your findings to the relevant administrators.

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Remote Hedis Review Nurse jobs near you
Infographic showing various Remote Hedis Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $71,500 per year, or $34.4 per hour.

HEDIS Review Nurse - Remote - Contract

HireOps Staffing, LLC

Dallas, TX • Remote

$42/hr

Full-time

Posted 5 days ago

Job description

This is a contract assignment that will start right away and end on April 30th 2024


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