Remote Clinical Quality Analyst (Lead HEDIS Abstractor & Over-Reader)

Remote Full-time
Russell Tobin is hiring Remote Senior Clinical Quality Analysts (Lead HEDIS Abstractors & Over-Readers) to support our client's 2026 HEDIS season from December/January to April/May 2026. Primary responsibilities in this role include but are not limited to: 1. Supervision of Contractors (Clinical Quality Analyst) performing overread and research of non-compliant members in HEDIS® quality measures. 2. Partner with the Operational Strategy & Oversight staff to set priorities and troubleshoot any issues that arise. 3. Monitor performance reports available of the Clinical Quality Analyst and provide remediation as needed. Responsibilities: • Perform quality assurance on Clinical Quality Analyst performance as it relates to chart review and ability to perform research and collection of chart data for HEDIS® and HEDIS® -like quality measures. •Provide remediation training as needed. • Maintains HIPAA standards and confidentiality of protected health information; reports critical incidents immediately • Communicates questions and/or concerns to the Operational Strategy & Oversight staff, as appropriate, in a timely manner • Attends team meetings to provide information relating to clinical reviews and compliance • Successfully completes HEDIS® technical specification training and testing with a passing score of 95% or greater • Successfully completes HEDIS® software training and uses software correctly • Performs other duties as assigned Qualifications: • Management/ supervision experience • At least 1 year of HEDIS abstraction / medical record review experience is required. • Clinical licensure - RN, LPN, LVN preferred but not required • Reliable hardwired high-speed internet access (no Wi-Fi) required. • Private US-based in-home office that follows HIPAA regulations required. Training Schedule: Monday - Friday 8 - 5 PM EST Post Training Schedule: Monday - Friday 8-5 Local Time (EST, CST, MST or PST) Pay Range: $35-40/hour Apply tot his job
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