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Remote Hedis Jobs in Raleigh, NC (NOW HIRING)

Amerihealth Caritas

Mgr Quality Management

Raleigh, NC · On-site +1

This position oversees integration of quality monitoring and interventions for improving HEDIS ... For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet ...

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Remote Hedis information

See Raleigh, NC salary details

$19

$33

$46

How much do remote hedis jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for remote hedis in Raleigh, NC is $33.42, according to ZipRecruiter salary data. Most workers in this role earn between $28.27 and $37.40 per hour, depending on experience, location, and employer.

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

Remote HEDIS professionals often encounter challenges such as managing large volumes of medical records, ensuring data accuracy, and navigating various electronic health record (EHR) systems. Working remotely can also require strong time management and self-motivation, as well as clear communication with team members and providers. To address these challenges, it's helpful to establish a structured daily routine, utilize secure and reliable technology, and participate in regular virtual meetings to stay aligned with team goals and updates.

What Are Remote HEDIS Jobs?

Remote HEDIS jobs allow you to work from home to review and process medical records for the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS is an industry measurement plan that evaluates factors like access to care, the effectiveness of care, and experience of care to help healthcare facilities improve their daily operations. Remote HEDIS positions may involve gathering offsite data to enter into the system or auditing existing data to verify its accuracy. HEDIS data submissions are made annually, but data collection and verification is done throughout the year so companies can ensure the information is ready to submit on-time. In a virtual HEDIS job, you may work for a single medical office or provide support for multiple healthcare facilities.

What are Remote HEDIS jobs?

Remote HEDIS jobs involve working with the Healthcare Effectiveness Data and Information Set (HEDIS) from a remote location, typically in roles such as abstractors, reviewers, or coordinators. Professionals in these positions collect, review, and analyze health care data to ensure compliance with quality measures used by health plans and providers. These jobs often require familiarity with medical records, coding, and healthcare regulations. Remote HEDIS roles offer flexibility and are in demand during the annual HEDIS reporting season, usually requiring strong attention to detail and computer proficiency.

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

To thrive as a Remote HEDIS Abstractor, you need a strong background in healthcare data abstraction, knowledge of HEDIS measures, and experience with medical records, often supported by an RN, LPN, or similar clinical credential. Familiarity with HEDIS-specific software, electronic health records (EHRs), and data management systems is typically required. Attention to detail, strong organizational skills, and effective communication are vital soft skills for ensuring accuracy and collaborating with remote teams. These skills ensure reliable data collection and reporting, which are essential for healthcare quality improvement and regulatory compliance.

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

AspectRemote HedisRemote Medical Reviewer
Required CredentialsRN, LPN, or Medical DegreeMD, DO, or Nurse Practitioner
Work EnvironmentHome-based, healthcare settingHome-based, healthcare setting
Industry UsageUtilized in Medicaid/Medicaid Managed CareUsed in insurance, utilization review
Common Search IntentCompare roles in Medicaid reviewCompare medical review roles in insurance

Remote Hedis specialists typically hold nursing or medical degrees and focus on HEDIS data collection and quality measures for Medicaid plans. Remote Medical Reviewers often have advanced medical degrees and perform comprehensive case reviews for insurance companies. While both roles are remote healthcare positions, they differ mainly in credentials and specific job functions.

More about Remote Hedis jobs
What are the most commonly searched types of Hedis jobs in Raleigh, NC? The most popular types of Hedis jobs in Raleigh, NC are:
What are popular job titles related to Remote Hedis jobs in Raleigh, NC? For Remote Hedis jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Hedis jobs in Raleigh, NC look for? The top searched job categories for Remote Hedis jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Hedis jobs? Cities near Raleigh, NC with the most Remote Hedis job openings:
Remote Hedis jobs near you
Infographic showing various Remote Hedis job openings in Raleigh, NC as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $69,504 per year, or $33.4 per hour.
Mgr Quality Management

Mgr Quality Management

Amerihealth Caritas

Raleigh, NC • On-site, Remote

Full-time

Medical, Retirement, PTO

Posted 9 days ago

AmeriHealth Caritas rating

8.5

Company rating: 8.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

87th of 261 rated insurance

Job description

Under the direction of the Director, Quality Management, the Manager of Quality Management is responsible for providing oversight, direct supervision and day-to-day management of the Quality Management Team. This position oversees integration of quality monitoring and interventions for improving HEDIS rates and provides process assistance to business owners for performance improvement projects. The incumbent provides direction and support to the Quality Management team and assists the Director in ensuring Plan compliance with state regulations and accreditation standards.

  • Directs the Quality Operations Program, following the National Committee for Quality Assurance (NCQA) Standards and Guidelines Quality Management, as well as, the contract with the State and requirements of regulatory bodies
  • Maintains current knowledge of Health Plan Policy and Procedures, State Requirements, NCQA Standards and HEDIS specifications.
  • Participates in the planning, developing, and implementing Health Plan activities related to the HEDIS process, improving HEDIS rates and member satisfaction.
  • Ensures the Quality Management Team complies with all applicable statutory provisions, contracts, and established policies and administrative procedures.
  • Participates and assists in the development of all necessary protocols, policies and procedures, operational strategies and plans to develop and implement Quality Management programs.
  • Ensures complete, accurate and timely reporting to regulatory bodies.
  • Supports the development and implementation of quality management programs and pilot programs designed to improve HEDIS rates and/or member satisfaction.

  • Identifies barriers to project and program success and works toward resolution by informing the accountable functional area and presenting plans to resolve the issue when possible.

Education/ Experience:

  • Bachelor's Degree in a Health Related field required.
  • RN strongly preferred.
  • 3 to 5 years management experience in Quality Improvement.
  • 10 or more years progressively responsible experience in a health related position.

Other Skills:

  • Performance/Quality Improvement Coordinator (Manager) shall be a certified professional in healthcare quality (CPHQ) or certified in health care quality and management (CHCQM) or comparable education and experience in data and outcomes measurement required.
  • Previous experience in managed care required.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Employment Type: FULL_TIME

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