[Remote] Clinical Quality Analysts - HEDIS

Remote, USA Full-time
Note: The job is a remote job and is open to candidates in USA. Russell Tobin is seeking experienced Clinical Quality Analysts for the 2026 HEDIS season. In this role, you will support the Quality Optimization and Insights team by overseeing non-compliant members in HEDIS quality measures, conducting medical record reviews, and ensuring compliance with quality standards. Responsibilities • Perform medical record reviews for HEDIS® and HEDIS®-like measures to verify clinical data elements abstracted by vendors, ensuring compliance with production goals. • Conduct over-reads of medical records to validate accuracy and adherence to quality measures. • Maintain HIPAA standards and confidentiality of protected health information; report critical incidents immediately. • Communicate any questions or concerns to your Contractor Supervisor or assigned Specialist promptly. • Attend team meetings to share insights and updates related to clinical reviews and compliance. • Successfully complete HEDIS® technical specification training and testing with a passing score of 95% or greater. • Utilize HEDIS® software effectively following training completion. • Perform additional duties as assigned to support the team’s objectives. Skills • HEDIS experience with specific experience with any of the following quality measures: BPD, CBP, CCS, COL, COA, HBD, EED, CIS, DVSCH, IMA, LSC, PPC, TRC, and WCC. • Overread experience of these measures. • Research-oriented with excellent proofreading skills. • Strong critical thinking and analytical abilities. • Exceptional time management and prioritization skills. • Effective communication skills. • Proficiency in Microsoft Office applications, including Word, Excel, Adobe, and PowerPoint. • Self-starter with a results-driven approach to work. • Intermediate proficiency in Microsoft Office applications. • HEDIS experience with LTSS, FFR, and FFS a plus. Benefits • Comprehensive healthcare coverage (medical, dental, and vision plans) • Supplemental coverage (accident insurance, critical illness insurance and hospital indemnity) • A 401(k)-retirement savings • Life & disability insurance • An employee assistance program • Identity theft protection • Legal support • Auto and home insurance • Pet insurance • Employee discounts with some preferred vendors 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 Apply tot his job
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