#23652 HEDIS Quality Specialist

nTech Workforce; Columbia (MD); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical, Vision, Dental insurance

401K Retirement Plan

Life/AD&D

Short/Long Term Disability

Employee Referral Bonus

Bi-Weekly Direct Deposit

Job summary

nTech Workforce is seeking a Clinical Medical Review Nurse to support a HEDIS retrospective project. You will drive medical record retrieval, abstraction, and provider outreach while ensuring compliance and high care standards.

The role requires on-site training in Meriwether, MD with hybrid remote work options for MD/DC/VA residents and occasional travel to provider sites.

Qualifications

• 3+ years of clinical background/experience.
• 5+ years of HEDIS and quality measures experience (or 10 years without degree/licensure).
• RN/LPN/CNA licensure or compact state allowed.
• Experience in medical record retrieval and provider outreach.
• Proficient with MS Office and EMR systems.

Responsibilities

• Retrieve and abstract medical records for HEDIS projects.
• Outreach to provider offices by phone, email, fax, and EMR portals.
• Occasionally visit provider sites to obtain paper records.
• Complete onboarding and training during first two weeks.
• Review clinical documentation using EMR systems (Epic, Athena).
• Collaborate with quality managers in a remote team environment.

Skills

Medical record retrieval

Provider outreach

Quality measures

EMR navigation

MS Office

Remote teamwork

Education

RN/LPN/CNA licensure or certification

Bachelor's degree (optional)

Tools

Epic

Athena

Excel

Word

PowerPoint

Microsoft Teams

Job description

nTech Workforce has an #23652 HEDIS Quality Specialist

Terms of Employment

• Contract Duration: 5 months
• Work Location: Primarily Remote (Hybrid focus for candidates residing in MD, DC, or VA; PA and DE considered). Requires mandatory on-site training in Meriwether, MD the week of December 14th and occasional travel to provider sites.

Overview:

Work with a leading healthcare organization as a Clinical Medical Review Nurse supporting the annual HEDIS retrospective project. In this role, you will drive medical record retrieval, abstraction, provider outreach, and quality measure management. Joining a collaborative and quality-focused team, you will play a critical role in evaluating medical records to ensure organizational compliance and high standards of care.

Key Responsibilities:

• Conduct medical record retrieval, abstraction, pen management, and quality measure overreads for HEDIS retrospective projects.
• Perform daily outreach to provider offices via phone, email, fax, and remote EMR portal access to request and secure medical records.
• Conduct occasional local on-site visits to provider offices to retrieve paper records when necessary.
• Complete comprehensive onboarding, orientation, and environment navigation virtual trainings during the first two weeks of assignment.
• Utilize EMR systems (such as Epic, Athena) and internal software tools to review clinical documentation accurately.
• Collaborate closely with quality managers and team members in a proactive, remote team environment.

Required Qualifications:

• Minimum 3 years of clinical background/experience combined with at least 5 years of recent HEDIS and quality measures experience (or 10 years of recent relevant HEDIS experience for candidates without a Bachelor's degree or RN/LPN license, such as CNAs, Medical Billers, or Coders).
• Active RN, LPN, or CNA licensure/certification (Compact state licenses accepted).
• Demonstrated experience in medical record retrieval, abstraction, and direct provider outreach.
• Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint) and Microsoft Teams.
• Reside within reasonable proximity to the MD/DC/VA area (PA and DE considered) with willingness to travel locally to provider sites as needed.
• Availability to attend mandatory, on-site, in-person training at the Meriwether office the week of December 14th.
• Strict availability during the project blackout period from February through April (no extended planned vacations/absences).

Preferred Qualifications:

• Prior experience performing HEDIS overreads and high-level quality audits.
• Familiarity with major EMR systems such as Epic and Athena.
• Dual-monitor remote work setup established.

Benefits Information

• Medical Insurance; Vision Insurance; Dental Insurance
• 401K Retirement Plan (Discretionary Match Offered)
• Ancillary Coverage (Life, AD&D, Short Term / Long Term Disability)
• Employee Referral Bonus
• Bi-Weekly Direct Deposit
• Note: As a contingent worker with nTech, you'll be paid for all approved hours worked; paid time off and paid holidays are not provided.
• nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.