HEDIS Clinical Review Nurse

nTech Workforce; Washington, Baltimore (District of Columbia, MD); Remote; USD 47,000 - 67,000; Full time

Job summary

nTech Workforce seeks a HEDIS Clinical Review Nurse to support an annual HEDIS retrospective project. You will drive medical record retrieval, abstraction, provider outreach, and quality measure management in a team focused on compliance and high-quality care.

This W2 contract runs for 5 months and is primarily remote, with mandatory on-site training in Meriwether, MD and local travel as needed. Candidates must hold an active RN/LPN/CNA license and reside near MD/VA/DC.

Qualifications

• Minimum 3 years of clinical background with 5+ years in HEDIS/quality measures.
• Active RN, LPN, or CNA licensure (compact states accepted).
• Experience with medical record retrieval and provider outreach.

Responsibilities

• Conduct medical record retrieval and abstraction for HEDIS projects.
• Perform outreach to provider offices by phone, email, fax, and EMR portal.
• Occasional on-site visits to retrieve paper records as needed.
• Complete onboarding and virtual trainings in the first two weeks.
• Review clinical documentation using EMR systems (Epic, Athena).
• Collaborate with quality managers in a remote team setting.

Skills

HEDIS experience

Medical records abstraction

Provider outreach

MS Office & Teams

Education

Bachelor’s degree preferred

Tools

Epic EMR

Athena EMR

MS Office

Remote collaboration tools

Job description

***Candidates MUST BE located in Maryland, Virginia, (or) DC states only!

***Candidates MUST HAVE an active RN license from Maryland, Virginia, (or) DC states

Role:

HEDIS Clinical Review Nurse

W2 Contract:

5 Months

Location:

Primarily remote

• Requires mandatory on-site training in Meriwether, MD, the week of December 14th and occasional travel to provider sites.

Pay Rate:

$41.49/hour on W2-All inclusive

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.