HEDIS Nurse

Medasource; United States; On-site; Full time

Job summary

Medasource is seeking an experienced HEDIS Nurse to join their Quality Improvement team. This position involves collecting, reviewing, and abstracting medical records for HEDIS reporting, ensuring compliance with regulations and driving improvements in patient care quality.

Benefits

Vision insurance

Medical insurance

Qualifications

• Minimum of 2 years of clinical nursing experience.
• 1+ years of HEDIS abstraction or quality improvement experience strongly preferred.
• Active and unrestricted RN license in Indiana or compact licensure.

Responsibilities

• Conduct reviews of patient medical records to extract clinical data for HEDIS measures.
• Collaborate with departments to obtain necessary medical records.
• Assist in validation and auditing of data for accuracy.

Skills

Clinical Nursing

Data Abstraction

Regulatory Knowledge

Quality Improvement

Education

Registered Nurse (RN) license

Associate's or Bachelor’s Degree in Nursing (BSN)

Job description

Get AI-powered advice on this job and more exclusive features.

This range is provided by Medasource. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$32.00/hr - $38.00/hr

Direct message the job poster from Medasource

We are seeking an experienced HEDIS Nurse to join our Quality Improvement team. The HEDIS Nurse will be responsible for collecting, reviewing, and abstracting medical records to support Healthcare Effectiveness Data and Information Set (HEDIS) reporting. This role plays a critical part in ensuring the organization's compliance with regulatory and accreditation requirements and in driving improvements in patient care quality.

Key Responsibilities:

• Conduct thorough reviews of patient medical records to extract relevant clinical data in accordance with HEDIS measures and NCQA guidelines.
• Accurately abstract data and enter findings into HEDIS-specific software and internal systems.
• Collaborate with internal departments and external providers to request and obtain necessary medical records and documentation.
• Maintain up-to-date knowledge of HEDIS measures, regulatory requirements, and best practices.
• Assist in the validation and auditing of data to ensure accuracy and completeness.
• Participate in training sessions, meetings, and other quality improvement initiatives as needed.
• Identify trends, gaps, and opportunities for quality improvement based on HEDIS results.
• Support annual HEDIS project cycles including pre-season preparation, data collection, and post-season analysis.

Qualifications:

• Education: Registered Nurse (RN) license required; Associate's or Bachelor’s Degree in Nursing (BSN) preferred.
• Experience: Minimum of 2 years of clinical nursing experience; 1+ years of HEDIS abstraction or quality improvement experience strongly preferred.
• Licensure: Active and unrestricted RN or LPN license in Indiana or compact licensure.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Consulting

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at Medasource by 2x

Inferred from the description for this job

Vision insurance

Medical insurance

Get notified when a new job is posted.

Sign in to set job alerts for “Nurse” roles.

Telehealth Triage Registered Nurse (New York + Compact State RN License Required)

Want to work with us but don't see the right job listed?

Santa Monica, CA $68,000.00-$72,000.00 3 weeks ago

Remote RN Telephone Triage (NYS license required)

Williamsville, NY $68,000.00-$71,500.00 8 months ago

Appeals Nurse Consultant - Remote Position

Registered Nurse Remote - MA RN License Required

Clinical Review Nurse/Prior Authorization

Texas, United States $38.00-$43.00 4 days ago

Remote Registered Nurse (RN) Case Manager

Virtual Clinical Educator- Call Center RN

Remote Registered Nurse (RN) Case Manager

Appeals Nurse Consultant - Remote Position

Remote Registered Nurse (RN) Case Manager

REMOTE F/T OVERNIGHT RN TELEPHONE TRIAGE (NYS LICENSED)

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.