HEDIS Nurse

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

$30.00/hr - $40.00/hr

🔹 Now Hiring: HEDIS Nurse (RN or LPN)

📍 Remote | ⏱ Flexible Schedule (Must be available 9 AM – 3 PM CST)

We are seeking a highly skilled HEDIS Nurse to join our Quality Operations team. This role is ideal for someone who thrives in a high‑production environment, is technically strong, and has a passion for improving quality outcomes. Both RNs and LPNs are encouraged to apply.

You will play a key role in ensuring accurate HEDIS reporting, quality improvement, and clinical data validation.

Responsibilities include:

• Review and abstract medical records for HEDIS and HEDIS‑like measures
• Perform data entry, data collection, and data mining for assigned markets
• Highlight Stars/HEDIS opportunities for clinical staff
• Support quality initiatives by requesting and obtaining medical records
• Identify trends, gaps in care, and barriers impacting quality results
• Navigate multiple systems, screens, and software platforms efficiently
• Provide administrative and clerical support for reporting and special projects
• Maintain current knowledge of HEDIS/Stars program requirements
• Conduct inbound and outbound calls related to quality requirements

• Review records to verify clinical data elements for reporting
• Communicate additional record pursuits to team members
• Uphold HIPAA standards and confidentiality
• Attend meetings and calls related to clinical review and compliance
• Successfully complete all HEDIS technical and software training
• Perform additional duties as assigned

• RN or LPN
• 2+ years of HEDIS experience (strongly preferred)
• Strong proficiency in Excel (sorting/filtering large datasets of 100k+ members)
• Solid understanding of managed care and clinical quality requirements
• Strong medical record review and abstraction skills
• Excellent time management, prioritization, and attention to detail
• Highly proficient with Microsoft Office (Word, Excel, PowerPoint, Adobe)
• Critical thinker, self‑starter, and able to work independently without distraction
• Must be technically savvy and comfortable navigating multiple screens and software systems

• Flexible start/end times
• High‑impact role supporting quality improvement
• Join a team focused on accuracy, performance, and outstanding outcomes

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