Clinical Quality Research Analyst (HEDIS Registered Nurse)

Health Care Service Corporation; Chicago (IL); Remote; USD 60,000 - 134,000; Full time

Job summary

An established industry player is seeking a Clinical Quality Research Analyst to enhance healthcare quality through data collection and analysis for HEDIS projects. This role involves collaborating with internal teams and providers to ensure compliance with clinical guidelines and improve managed care products. Ideal candidates will have a strong nursing background, experience in healthcare quality, and excellent communication skills. Join this innovative organization to make a significant impact in the healthcare landscape while enjoying the flexibility of a telecommute role.

Qualifications

• Registered Nurse with a current Illinois license required.
• 3+ years of experience in healthcare or managed care.

Responsibilities

• Conduct data collection and abstraction for HEDIS projects.
• Analyze data and educate providers on HEDIS measures.

Skills

HEDIS medical record review

Data analysis skills

Verbal communication skills

Written communication skills

Problem-solving skills

Education

Registered Nurse (RN) license

Clinical practice experience

Tools

Statistical software

Job description

Clinical Quality Research Analyst (HEDIS Registered Nurse)

Join to apply for the Clinical Quality Research Analyst (HEDIS Registered Nurse) role at Health Care Service Corporation.

This position involves conducting data collection and abstraction of medical records for HEDIS and quality projects, including supplemental data collection. You will interact with internal staff, departments, and network providers/IPAs to ensure quality performance for Blue Cross managed care products. Responsibilities also include auditing clinical quality improvement projects, evaluating compliance with clinical practice guidelines, analyzing data, educating providers on HEDIS measures, identifying care gaps, and reporting results to stakeholders.

Required Qualifications

• Registered Nurse (RN) or licensed clinician with current, unrestricted Illinois license
• At least 3 years of clinical practice experience performing HEDIS medical record review
• Minimum of 3 years in healthcare or managed care, including quality improvement or project management
• At least 1 year of HEDIS medical record data abstraction experience
• Data analysis skills with knowledge of statistical software and methods
• Ability to adapt to changing priorities and manage multiple projects
• Strong verbal and written communication skills
• Problem-solving skills and diplomacy in difficult situations
• Experience in provider training presentation planning and delivery

Preferred Qualifications

• HEDIS experience
• Project management experience
• Knowledge of clinical quality innovation
• Familiarity with NCQA managed care programs
• This role is telecommute; candidate must reside within 250 miles of the posted location

Additional Details

Salary range: $60,300 - $133,400, based on skills and experience.

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