Clinical Quality Research Analyst (HEDIS Registered Nurse)

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

Job summary

Join a purpose-driven organization dedicated to improving healthcare quality as a Clinical Quality Research Analyst. This role involves conducting data analysis and interacting with healthcare providers to enhance quality performance. You'll be responsible for auditing clinical quality improvement projects and translating data into actionable insights. With a commitment to employee development, this innovative firm offers a robust benefits package and a collaborative work environment. If you're passionate about making a difference in healthcare, this opportunity is perfect for you.

Benefits

Health and wellness benefits

401(k) savings plan

Pension plan

Paid time off

Tuition reimbursement

Qualifications

• 3+ years of clinical practice experience in healthcare.
• Experience in HEDIS data abstraction and quality improvement.

Responsibilities

• Conduct data collection and abstraction for HEDIS projects.
• Interact with providers to educate on quality programs.

Skills

HEDIS medical record review

Data analysis

Problem resolution

Communication skills

Project management

Education

Registered Nurse (RN) license

Clinical practice experience

Tools

Statistical analysis software

Job description

Clinical Quality Research Analyst (HEDIS Registered Nurse) page is loaded

Clinical Quality Research Analyst (HEDIS Registered Nurse)

Apply locations IL - Chicago time type Full time posted on Posted 2 Days Ago time left to apply End Date: May 26, 2025 (23 days left to apply) job requisition id R0039408

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position is responsible for conducting data collection and abstraction of medical records for HEDIS and quality projects including supplemental data collection. Responsible for interacting with various internal staff, internal departments, and network providers/IPAs to ensure quality performance and results for blue cross managed care products. Responsible for auditing all aspects of BCBSIL clinical quality improvement projects and evaluating PCP/MG/IPA compliance with BCBSIL clinical practice guidelines. Also responsible for data analysis, interaction with providers’ practices and IPAs to educate on HEDIS measures, gaps in care and quality programs. Translate data into actionable information and determine areas for improvements as well as help implement actions toward improvement and report results to internal and external customers.

Required Job Qualifications:

• Registered Nurse (RN) OR licensed clinician with current, unrestricted license in Illinois

• Minimum of 3 years of clinical practice experience performing HEDIS medical record review

• Minimum of 3 years of Healthcare or Managed Care experience, including quality improvement and/or project management experience

• Minimum of 1 year HEDIS medical record data abstraction

• Data analysis experience, skills and knowledge of statistical analysis software, and statistical methods and meaning knowledge

• Ability to adapt to changing priorities and managing a wide range of quality projects

• Verbal and written communication skills

• Problem resolution skills and ability to work with difficult situations with respect and diplomacy

• Presentation planning and delivery experience for provider training

Preferred Job Qualifications:

• REQUIRED - HEDIS experience

• Must have Project Management experience

• Clinical Quality Innovation

• NCQA - Working knowledge of managed care programs

*This role is a telecommute must live within 250 miles from posted location.

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Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$60,300.00 - $133,400.00

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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,
Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association