HEDIS Specialist
Job title: HEDIS Specialist Location: Remote Hours: Monday–Friday, standard business hours based on candidate’s location Pay: $40.21/hr Overview This is a fully remote HEDIS Specialist role focused on improving behavioral health quality measures through data analysis, medical record review, and strategic interventions. The position supports HEDIS and Pay for Performance initiatives by partnering with clinical teams and health plans to drive compliance and improve outcomes. Ideal candidates will have hands-on HEDIS experience, strong chart abstraction skills, and an active RN or LPN license. This is a contract role through 12/31/26 with a 4/20/26 start date. Responsibilities: • Supervise and support interventions to improve behavioral health HEDIS and Pay for Performance measures • Partner with health plans and clinical leadership to identify and implement strategies that increase HEDIS rates • Develop and implement innovative compliance improvement initiatives with clinical staff • Prepare and present financial impact and ROI for initiatives needing added resources or funding • Serve as a liaison between quality improvement, medical management, and other departments • Monitor effectiveness of new and existing HEDIS and P4P initiatives • Analyze data trends and identify quality and clinical improvement opportunities • Ensure education and interventions are provided for members who fall into targeted measures Required Qualifications: • Healthcare experience with medical terminology, medical record review, coding, or similar work • HEDIS knowledge and prior HEDIS experience • Experience abstracting data from medical records • Active RN or LPN license #INDBD Pay: $40.21 per hour Benefits: • Dental insurance • Health insurance • Vision insurance Application Question(s): • What HEDIS measures would you consider yourself a subject matter expert? • What has been your biggest HEDIS-related challenge and how did you overcome it? • What would you consider an appropriate accuracy percentage as a HEDIS Reviewer? Work Location: Remote