Healthcare Compliance Expert - HEDIS

Remote Full-time
About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Healthcare Compliance & Care Coordination Expert
Type:Contract
Compensation:$70–$95/hour
Location:Remote

Role Responsibilities
• Develop long-horizon tasks that reflect real-world healthcare compliance and care coordination scenarios.
• Build deterministic rubrics to grade agent performance against verifiable ground truth.
• Create scenarios for regulatory compliance such as HIPAA documentation and CMS quality reporting.
• Design care coordination tasks like care plans and handoff documents aligned with clinical guidelines.
• Implement value-based care scenarios, including HEDIS/STAR gap closure and HCC coding.
• Work independently and asynchronously to ensure high-quality outputs.

Qualifications

Must-Have
• 3+ years in care coordination, case management, or healthcare compliance.
• Expertise in HEDIS and STAR measures, HCC coding, care plan documentation, value-based care contracts, or HIPAA program operations.
• Proficient in creating care coordination artifacts like care plans and compliance memos.
• Clear written communication skills for articulating reasoning and encoding it into deterministic rubrics.

Preferred
• RN, LCSW, CCM, or equivalent certification.

Compensation & Legal
• Hourly contractor
• Strong contributors are promoted based on task quality and throughput.

Application Process (Takes 20–30 mins to complete)
• Upload resume
• AI interview based on your resume
• Submit form

Resources & Support
• For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
• For any help or support, reach out to: [email protected]

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.

Remote

Skills:
Artificial Intelligence (AI), Benchmarking, Case Management, Clinical Practices/Protocols, Clinical Study Publications, Communication Skills, Content Management Systems (CMS), Documentation, Documentation Plan, Gap Closure, HIPAA (Health Insurance Portability and Accountability Act), Health Plan, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Maintain Compliance, Productivity Management, Regulatory Compliance, Research Laboratory, Writing Skills

About the Company:
Mercor

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