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Remote Hedis Reviewer Jobs in Florida (NOW HIRING)

Remote Hedis Reviewer information

What is a remote HEDIS reviewer?

A Remote HEDIS Reviewer is a healthcare professional who evaluates medical records and data from a remote location to ensure compliance with HEDIS (Healthcare Effectiveness Data and Information Set) measures. HEDIS is a set of standardized performance measures used to assess the quality of care and services in health plans. Remote HEDIS Reviewers typically review patient charts, extract relevant information, and record their findings in electronic systems. Their work helps health plans report accurate quality data, meet regulatory requirements, and improve patient care. This role often requires experience in nursing, coding, or healthcare data analysis, as well as familiarity with medical terminology and electronic health records.

What does a remote HEDIS reviewer do?

A typical day for a Remote HEDIS Reviewer involves reviewing and abstracting medical records to ensure compliance with HEDIS quality measures, documenting findings in electronic systems, and meeting productivity and accuracy targets. Communication and collaboration are primarily managed via secure digital platforms—such as email, video meetings, and instant messaging—enabling regular check-ins with team leads and peers. While much of the work is independent, reviewers often participate in virtual team meetings to discuss updates, share best practices, and address any challenges. Time management and self-motivation are essential, as is the ability to adapt to evolving guidelines and tight deadlines during the HEDIS season.

What skills and qualifications are needed to thrive as a remote HEDIS reviewer?

To thrive as a Remote HEDIS Reviewer, you need a background in healthcare, strong knowledge of HEDIS measures, and experience with medical record review, often supported by an RN or LPN license. Familiarity with HEDIS abstraction software, electronic medical records (EMRs), and secure data management systems is typically required. Exceptional attention to detail, time management, and strong written communication are critical soft skills for excelling in this remote role. These skills ensure accurate data abstraction, compliance with regulatory standards, and effective contribution to quality improvement initiatives.

What is the difference between Remote Hedis Reviewer vs Remote Medical Reviewer?

AspectRemote Hedis ReviewerRemote Medical Reviewer
Required CredentialsRN, LPN, or other healthcare certificationsMD, DO, or advanced healthcare certifications
Work EnvironmentHome-based, reviewing healthcare records for Medicaid/MedicareHome-based, reviewing medical records for insurance or legal cases
Employer & Industry UsageHealth plans, Medicaid/Medicare providersInsurance companies, legal firms, healthcare organizations
Common Search & ComparisonYesYes

The main difference is that Remote Hedis Reviewers typically hold nursing or healthcare certifications and focus on Medicaid/Medicare compliance reviews, while Remote Medical Reviewers often have medical degrees and handle broader medical record assessments for insurance or legal purposes. Both roles are home-based and require healthcare expertise, but they serve different industry needs.

What are popular job titles related to Remote Hedis Reviewer jobs in Florida?

For Remote Hedis Reviewer jobs in Florida, the most frequently searched job titles are:

What cities in Florida are hiring for Remote Hedis Reviewer jobs?

Cities in Florida with the most Remote Hedis Reviewer job openings:

Infographic showing various Remote Hedis Reviewer job openings in Florida as of August 2026, with employment types broken down into 87% Full Time, and 13% Part Time. Highlights an 100% Remote job distribution.

Senior Health Educator- Clinical Transplant Nurse- Remote

Saint Petersburg, FL • Remote


Molina Healthcare
Health Care and Social Assistance • 10K+ employees

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

171st of 315 rated insurance

People enjoy working here

Good employer

Recommended by students


$49K - $98K/yr

Full-time

Re-posted 6 days ago


Job description

JOB DESCRIPTION Job Summary

Provides senior level support for health education activities.  Responsible for developing, implementing, and maintaining health plan health education programs.  Assists in identifying health education program needs, researching and developing health education and disease management materials, and maintenance of member quality programs.  Conducts data collection, reporting, and monitoring in accordance with established state/federal/National Committee for Quality Assurance (NCQA) standards and regulations.

We are searching for experience as a Certified Clinical Transplant Nurse.  Please include any experience in these qualifiers on your resume. This is for a pediatric population.  

Essential Job Duties

• Develops, implements and evaluates health education programs for members within the Molina network and the broader community.  
• Provides oversight and assistance to providers in meeting health education contract requirements.  
• Serves as a resource for health educators in the resolution of issues that may arise during the implementation of quality improvement (QI) interventions. 
• Identifies, designs, implements, and evaluates health education interventions to meet the needs of the targeted population based on priorities established by the department and current contracts. 
• Conducts population, geographic, and member-specific needs assessments.
• Coordinates the health education services assessment of Independent Physician Association (IPAs) and medical groups as required and collaborates with other quality improvement (QI) staff on oversight.
• Represents as a liaison to internal departments, community-based organizations (CBOs), social service agencies and public health departments to ensure that Molina resource information is current and available.
• Participates in the development of internal resources in collaboration with other departments identified in the annual work plan. 
• Reviews and updates health education materials and programs, including preventive care guidelines, incentive packets, the health plan website and communications to providers. 
• Successfully engages members in health promotion via direct member calls.
• Coordinates care of members from call tracking boxes and health education voicemails, including connecting members to appropriate programs and resources.
• May collaborate with various grant recipients, state and local entities that work toward improving the health of Molina members.
• Participates in QI planning and project work to further QI goals (e.g., Healthcare Effectiveness Data and Information Set (HEDIS) activities, strategic planning, and special projects).
• Provides input on the design and functionality of all utilized databases.
• May serve as the designated QI representative at various external activities to include immunization, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), chronic condition collaborative and other work group meetings.
• Participates in QI planning and project work to further QI goals (e.g., HEDIS activities, and special projects).
• Provides training and support to new and existing health education team members.
• This position may require same day out of office travel 0 - 80% of the time, depending upon state-specific needs.
• This position may require multi-day overnight travel on occasion, depending upon state-specific needs.
 

Required Qualifications

• At least 3 years of experience in a health education-related capacity, and at least 1 of year experience working with a wide range of member populations within a managed care setting, or equivalent combination of relevant education and experience. 
• Ability to build relationships with community-based organizations (CBOs).
• Strong customer service skills.
• Knowledge of available community resources.
• Knowledge and understanding of HEDIS and NCQA.
• Critical-thinking, problem-solving and analytical skills.
• Ability to navigate change with flexibility and a positive outlook.
• Effective verbal, written and interpersonal communication skills.
• Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.
 

Preferred Qualifications

• Experience with Medicaid, Medicare, and/or Marketplace government-sponsored programs.  
• Experience working with the Medicaid population.
• Certified Health Education Specialist (CHES).
 

#PJQA

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $49,930 - $98,000 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.


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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

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