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Hard Skills HEDIS RN Experience with HEDIS software Change Healthcare Datavance QSI Excel Soft Skills Strong analytical skills Attention to detail Effective communication Job Type This is a contract position with a duration of 5 Month(s). Work Site This is a fully remote position. Work Environment 100% Remote, equipment will be sent out. First Shift hours M-F. Candidates cannot currently be working at Anthem or United Healthcare as that would be a conflict of interest.
We are seeking a dedicated and meticulous HEDIS Nurse to assist with the collection, analysis, and presentation of healthcare data. The HEDIS Nurse will be responsible for managing all aspects of the HEDIS (Healthcare Effectiveness Data and Information Set) process, including data collection, verification, and report generation. Our ideal candidate will have experience with HEDIS measures, strong analytical skills, and a deep understanding of healthcare systems and regulations. Ultimately, the HEDIS Nurse ensures that our healthcare services maintain a high level of quality, effectiveness, and compliance with regulatory standards. Responsibilities: * Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards * Review medical records and abstract data for HEDIS and other measure sets in compliance with standards * Track and report on issues and outcomes related to abstractions and over-reads * Communicate outcomes of abstraction and oversight activities with health plans and vendors when required * Perform other quality initiatives as necessary
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