HEDIS Seasonal Nurse

Position Details Job Title: Review Nurse (RN) – HEDIS Employment Type: W2 Contract through W3R Consulting Duration: 5 months, with possibility of extension Location:100% Remote – New Mexico Role Overview This position is part of the HEDIS business and involves reviewing and auditing patient medical records to ensure documentation supports applicable HEDIS measures and quality-of-care standards. The Review Nurse will Review and abstract medical record documentation for HEDIS measures. Apply structured auditing criteria and accurately enter audit results into the health plan’s database. Review provider documentation to validate that members received care according to specific HEDIS measure requirements. Verify documentation and data related to medical record retrieval/chase statuses. Maintain high productivity and an error rate of less than 5% for record abstraction and data entry. Support annual HEDIS reporting requirements associated with NCQA standards. Maintain HIPAA compliance and confidentiality of member and company information.

Required Qualifications

Active, unrestricted RN license in New Mexico. Clinical nursing experience. Experience with HEDIS, medical record review, chart review, quality assurance, utilization review, or medical record/site audits. Knowledge of medical terminology, standard medical practices, quality improvement processes, and applicable regulatory/accreditation standards. Strong written and verbal communication skills. Proficiency with Microsoft Word and Excel. Strong attention to detail and computer/data-entry skills. HEDIS or medical record abstraction/auditing experience is highly relevant for this position.