HEDIS Data Quality Specialist — Hybrid

Healthfirst, Inc.; New York (NY); Hybrid; USD 69,000 - 100,000; Full time

Benefits offered by this job

Health insurance

Dental coverage

Vision coverage

401k contributions

Incentive programs

Job summary

Healthfirst, Inc. is seeking a Clinical Quality Specialist to perform HEDIS medical record review, data abstraction, and data validation to support HEDIS reporting and quality improvement initiatives.

The role collaborates with providers, vendors and internal teams to ensure NCQA, CMS, state, and organizational compliance, while supporting data integrity and audit readiness. Hybrid work model with remote and office-based duties; office location is 100 Church Street, New York, NY.

Qualifications

• Bachelor’s degree in Nursing, Public Health, Health Administration, Healthcare Management, Public Policy, or related field.
• Knowledge of MS Office Applications.

Responsibilities

• Performs HEDIS medical record review, abstraction, data entry and validation activities.
• Reviews and validates clinical documentation and coding from EMRs and provider records.
• Ensures accuracy, completeness and integrity of HEDIS data for regulatory reporting.
• Identifies and resolves data discrepancies and documentation gaps.
• Supports internal and external HEDIS audits and audit readiness activities.
• Collaborates with Quality Improvement, Analytics, Coding and operational teams.

Skills

HEDIS measures knowledge

Clinical documentation standards

Healthcare quality programs

MS Office applications

EMR systems familiarity

Data abstraction tools

Education

Bachelor’s degree in Nursing, Public Health, Health Administration, Healthcare Management, Public Policy, or related field

Tools

MS Office Applications

EMR systems

Data abstraction tools

Job description

Healthfirst, Inc. is seeking a Clinical Quality Specialist to perform HEDIS medical record review, data abstraction, and data validation to support HEDIS reporting and quality improvement initiatives.

The role collaborates with providers, vendors and internal teams to ensure NCQA, CMS, state, and organizational compliance, while supporting data integrity and audit readiness. Hybrid work model with remote and office-based duties; office location is 100 Church Street, New York, NY.