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

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