[Remote] Clinical Quality Analysts - HEDIS

Remote 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
Apply Now

Similar Opportunities

Manager, Regional Operational Excellence

Remote

Airbnb Property Manager/Operations Manager/Assistant to Owner of Airbnbs

Remote

Product Manager, Guest Discovery & Merchandising

Remote

Air BnB Cleaning Service Provider

Remote

Senior Employee Growth & Development Specialist

Remote

Claims Learning and Development Leader

Remote

Instructional Design and Training Consultant job at Henry Ford Health System in Detroit, MI

Remote

Junior Training Department Specialist

Remote

Contract Writer for a Book on Mom Guilt

Remote

B2B Content Writer (Remote within LATAM region, Contract)

Remote

Legal Research - Public Trial Sixth Amendment

Remote

Experienced Overnight Customer Service Representative – Financial Services Support Specialist – Remote Opportunity

Remote

Experienced Part-Time Customer Service Representative – Flexible Hours and Comprehensive Benefits with blithequark

Remote

Hybrid Customer Assistance Representative Part Time – Delivering Exceptional Travel Experiences at blithequark in Indianapolis, IN, US

Remote

Remote Bookkeeper-PT/FT,Flex Hours,Must be good w/Quickbooks,Growth Oppty

Remote

**Experienced Full Stack Sales Operations Manager – B2B High Tech Sales Enablement and Strategic Partnership Development**

Remote

Experienced Customer Care Sales Manager for Financial and Insurance Solutions – Remote Work Opportunity with Unlimited Earning Potential

Remote

**Experienced Tutor - ACT/SAT English/Reading Prep in Chattanooga, TN**

Remote

Now Hiring: FULL TIME Virtual Data Entry At American Airlines ?

Remote

**Experienced Chat Support Representative – Environmental Preservation and Community Engagement**

Remote
← Back to Home