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

Remote Full-time
Note: The job is a remote job and is open to candidates in USA. Russell Tobin is hiring Remote Senior Clinical Quality Analysts to support our client's 2026 HEDIS season. The role involves supervising contractors, monitoring performance reports, and ensuring compliance with HEDIS quality measures. Responsibilities • Supervision of Contractors (Clinical Quality Analyst) performing overread and research of non-compliant members in HEDIS® quality measures. • Partner with the Operational Strategy & Oversight staff to set priorities and troubleshoot any issues that arise. • Monitor performance reports available of the Clinical Quality Analyst and provide remediation as needed. • 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 Skills • Management/ supervision experience • At least 1 year of HEDIS abstraction / medical record review experience is required. • Reliable hardwired high-speed internet access (no Wi-Fi) required. • Private US-based in-home office that follows HIPAA regulations required. • Clinical licensure - RN, LPN, LVN preferred but not required Company Overview • Russell Tobin is a staffing and recruiting company that provides recruitment and staffing advisory services. It was founded in 2010, and is headquartered in New York, New York, USA, with a workforce of 201-500 employees. Its website is http://russelltobin.com.
Apply Now

Similar Opportunities

Remote HEDIS Specialist

Remote Full-time

Salesforce Admin

Remote Full-time

Proposal Support Analyst-Dental

Remote Full-time

Lead Customer Service Representative - Walk In Center

Remote Full-time

Pre-Service Review Nurse RN-Remote in PST or MST-California RN License

Remote Full-time

Staff Pharmacist, Fulfillment- Amazon Pharmacy

Remote Full-time

Urgently Hiring: Want Temporary Workforce Management Real Time

Remote Full-time

AV Learning Developer Spring 2024 Intern – Remote in Dallas, TX

Remote Full-time

Assistant Property Manager / Airbnb Co-Host

Remote Full-time

Customer Service Representative – Luxury Retail (Remote)

Remote Full-time

Experienced Customer Service Representative – Behavioral Health Advocate and Support Specialist (Monday-Friday 10:45am -7:15pm EST)

Remote Full-time

Experienced Customer Success Manager – Investment Management Client Relationship Development and Growth Strategist at blithequark

Remote Full-time

Virtual Bookkeeper | BELAY | $20 $25 | Remote (US)

Remote Full-time

Entry Level TikTok Data Entry Specialist – Remote Opportunity for Detail-Oriented Individuals to Join the Thriving Social Media Industry

Remote Full-time

JBC – Freelance Product Development Coordinator, Beauty – New York City, NY

Remote Full-time

Customer Service Focused Corporate Trainer-Traveling

Remote Full-time

Telephonic Case Manager, RN (FT, Remote)

Remote Full-time

QA Manager, Studio Development Games

Remote Full-time

Project Manager - Contract Furniture - HiTouch Remote

Remote Full-time

[Remote-Position] Tesla Remote Work At Home

Remote Full-time
← Back to Home