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HEDIS RN Clinical Quality Reviewer

Full-time

HumanEdge

HEDIS RN – Clinical Quality Reviewer

Manhattan, NY | 6 Openings | Hybrid | Full-Time

HumanEdge Healthcare Staffing is recruiting experienced HEDIS Registered Nurses for clinical quality review opportunities with a leading NYC health plan.

This is an excellent opportunity for nurses with hands-on HEDIS medical record abstraction experience who enjoy clinical quality improvement and administrative nursing.

Schedule

  • Tuesday–Thursday: On-site in Manhattan, 100 Church Street.
  • Monday and Friday: Remote.
  • Hours: 8:30 AM–5 PM.

Responsibilities

  • Perform medical record abstraction for HEDIS quality measures.
  • Review clinical documentation for accuracy and completeness.
  • Identify care gaps and support quality reporting.
  • Maintain abstraction accuracy and productivity standards.
  • Collaborate with quality improvement and clinical teams.

Non-Negotiable Requirements

  • Active RN license.
  • Minimum 1 year of HEDIS medical record review/abstraction experience.
  • Working experience with all three measures:
  • BCS-E – Breast Cancer Screening.
  • COL-E – Colorectal Cancer Screening.
  • EED – Eye Exam for Patients With Diabetes.
  • Ability to commute to Manhattan Tuesday–Thursday.

Assignment: Contract opportunity, minimum six months.

Important: General utilization review, chart review, or infection prevention abstraction alone does not substitute for the required HEDIS experience.

Vacancy posted 5 days ago
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