Remote HEDIS QA Overreader (Jan–Apr 2027)

Pride Health; United States; Remote; USD 48,000 - 58,000; Full time

Benefits offered by this job

Healthcare coverage

401(k)-retirement savings

Life & disability insurance

Employee assistance program

Legal support

Pet insurance

Employee discounts

Job summary

PrideGlobal is seeking a HEDIS-Clinical Quality Analyst to support QA activities related to HEDIS quality measures for 2027. This contract role is remote in the United States, with a Monday–Friday schedule from 8:00 AM to 5:00 PM EST and a January 2027 to April 2027 commitment.

The position pays $35 to $42 per hour, with pay based on experience, credentialing, and education. Responsibilities include chart reviews, provider outreach, and quality improvement activities within a HIPAA-compliant

Qualifications

• 1+ year of HEDIS and/or medical record review experience preferred.
• Healthcare, health plan, or managed care industry experience preferred.
• Intermediate or higher proficiency with Microsoft Office applications (Word, Excel, Adobe, PowerPoint).

Responsibilities

• Perform quality assurance reviews and overreads of HEDIS chart review and data collection.
• Provide remediation training and coaching based on quality findings.
• Maintain HIPAA compliance and confidentiality of PHI.
• Report critical incidents and communicate questions to leadership.
• Participate in team meetings and provide updates on clinical reviews and analyst performance.
• Complete HEDIS technical specification training/testing with 95%+ passing score.
• Conduct provider outreach and medical record requests to obtain compliant data.
• Perform other QA, chart review, and quality improvement duties.

Skills

HEDIS knowledge

Quality assurance

HIPAA compliance

Data integrity

Documentation

Education

RN/LPN/LVN licensure preferred

Tools

Microsoft Word

Microsoft Excel

Adobe

PowerPoint

Job description

PrideGlobal is seeking a HEDIS-Clinical Quality Analyst to support QA activities related to HEDIS quality measures for 2027. This contract role is remote in the United States, with a Monday–Friday schedule from 8:00 AM to 5:00 PM EST and a January 2027 to April 2027 commitment.

The position pays $35 to $42 per hour, with pay based on experience, credentialing, and education. Responsibilities include chart reviews, provider outreach, and quality improvement activities within a HIPAA-compliant