HEDIS LPN

Job Title:

HEDIS Licensed Practical Nurse (LPN)

Job Description

The HEDIS Licensed Practical Nurse (LPN) reviews, abstracts, and validates clinical information from medical records to support HEDIS quality initiatives and regulatory reporting requirements. This role works closely with quality improvement teams, providers, and health plan partners to identify care gap closure opportunities, ensure data accuracy, and support NCQA-compliant HEDIS reporting activities. The position focuses on medical record review, chart abstraction, electronic medical record navigation, and clinical documentation validation in a fully remote environment.

Responsibilities

+ Review and abstract clinical data from electronic medical records in alignment with HEDIS and NCQA guidelines.

+ Retrieve, organize, and validate medical records to support quality improvement and regulatory reporting initiatives.

+ Identify and document evidence of compliance for HEDIS measures through detailed chart reviews.

+ Evaluate medical records for completeness, accuracy, and appropriate clinical documentation.

+ Research and resolve discrepancies identified during chart abstraction and validation processes.

+ Collaborate with healthcare providers and internal quality teams to obtain missing documentation and support care gap closure efforts.

+ Maintain established productivity and quality standards for chart review and abstraction activities.

+ Utilize multiple electronic medical record platforms to locate and extract relevant clinical data.

+ Ensure strict compliance with HIPAA, confidentiality standards, and organizational policies regarding protected health information.

+ Participate in quality audits, training programs, calibration sessions, and team meetings.

+ Perform additional quality improvement and medical record review activities as assigned.

Essential Skills

+ Active, unrestricted Licensed Practical Nurse (LPN) license.

+ High school diploma or equivalent.

+ Minimum of 1 year of clinical nursing experience.

+ Experience reviewing medical records and interpreting clinical documentation.

+ Working knowledge of medical terminology, disease processes, laboratory results, medications, and preventive care guidelines.

+ Proficiency with Microsoft Office applications.

+ Proficiency with electronic medical record systems.

+ Strong attention to detail with excellent organizational and documentation skills.

+ Ability to work effectively in a healthcare or managed care environment.

+ Ability to handle confidential health information in compliance with HIPAA.

Additional

Skills & Qualifications

+ Previous HEDIS abstraction or chart review experience.

+ Experience in quality improvement, utilization management, or population health.

+ Knowledge of NCQA and HEDIS quality measures.

+

Experience with managed care, Medicaid, Medicare, or health plan operations.

+ Previous remote medical record abstraction experience.

+ Familiarity with multiple EMR platforms and chart retrieval processes.

+ Experience working within healthcare, medical records, or managed care environments.

+ Comfort working with clinical and non-clinical stakeholders to support quality initiatives.

Work Environment

This position operates in a 100% remote work environment, allowing you to perform all duties from a home-based or off-site location. You will work extensively with electronic medical records, multiple EMR platforms, and Microsoft Office applications to review and abstract clinical data. The role emphasizes adherence to HIPAA and confidentiality standards when handling protected health information. You will collaborate virtually with quality improvement teams, providers, and health plan partners through online meetings, training sessions, and calibration activities while maintaining productivity and quality standards in a structured remote setting.

Job Type & Location

This is a Contract position based out of Saint Louis, MO.

Pay and Benefits

The pay range for this position is $32.00 - $40.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the…