HEDIS Abstraction Subject Matter Expert(Part-Time Consultant)Remote

Hilabs; United States; Remote; USD 96,000 - 138,000; Part time

Job summary

Hilabs is seeking an experienced HEDIS Subject Matter Expert for a part-time remote consulting engagement with our Healthcare Product team. The role allows you to continue your current full-time work while contributing HEDIS expertise for 1 to 2 hours per day over the next 3 to 4 months.

Key responsibilities include providing HEDIS domain expertise to Product and Clinical teams, explaining HEDIS measure logic and NCQA guidelines, and reviewing abstraction workflows.

Qualifications

• 3+ years of hands-on HEDIS experience.
• Strong experience in HEDIS Abstraction.
• Experience in Over-Read, PSV, Quality Review, and Medical Record Review.
• Excellent understanding of NCQA HEDIS Technical Specifications.
• Strong knowledge of numerator, denominator, exclusions, and measure logic.
• Experience working across multiple HEDIS measures.
• Good communication and problem-solving skills.

Responsibilities

• Provide HEDIS domain expertise to Product and Clinical teams.
• Explain HEDIS measure logic and NCQA guidelines.
• Review and validate HEDIS abstraction workflows.
• Support Product, Engineering, and Data Science teams in implementing HEDIS measure logic.
• Participate in discussions related to healthcare quality measures and workflow improvements.
• Review AI-generated HEDIS abstraction outputs and provide domain feedback.

Skills

HEDIS experience

HEDIS abstraction

Over-Read/PSV/Quality Review

NCQA specs

Measure logic

Multi-measure experience

Communication skills

Job description

We are hiring experienced HEDIS Subject Matter Experts for a part-time remote consulting engagement with our Healthcare Product team.

This is an excellent opportunity for professionals who wish to continue their current full-time role while contributing their HEDIS expertise for 1 to 2 hours per day over the next 3 to 4 months.

Key Responsibilities

• Provide HEDIS domain expertise to Product and Clinical teams.
• Explain HEDIS measure logic and NCQA guidelines.
• Review and validate HEDIS abstraction workflows.
• Support Product, Engineering, and Data Science teams in implementing HEDIS measure logic.
• Participate in discussions related to healthcare quality measures and workflow improvements.
• Review AI-generated HEDIS abstraction outputs and provide domain feedback.

Required Skills

• 3+ years of hands-on HEDIS experience.
• Strong experience in HEDIS Abstraction.
• Experience in Over-Read, PSV, Quality Review, and Medical Record Review.
• Excellent understanding of NCQA HEDIS Technical Specifications.
• Strong knowledge of numerator, denominator, exclusions, and measure logic.
• Experience working across multiple HEDIS measures.
• Good communication and problem-solving skills.

Preferred Skills

• HEDIS SME or Team Lead experience.
• Exposure to CMS Star Ratings or HCC.
• Experience collaborating with Product, Clinical, or Engineering teams.
• Experience reviewing AI-assisted abstraction outputs is an added advantage.

Engagement Details

• Employment Type: Part-Time Consultant
• Duration: 3 to 4 Months
• Location: Remote
• Time Commitment: 1 to 2 Hours per Day (Flexible)
• Compensation: Best in the Industry