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

Remote, USA Full-time Posted 2025-11-03
Note: The job is a remote job and is open to candidates in USA. Russell Tobin is hiring Remote Senior Clinical Quality Analysts to support our client's 2026 HEDIS season. The role involves supervising contractors, monitoring performance reports, and ensuring compliance with HEDIS quality measures. Responsibilities • Supervision of Contractors (Clinical Quality Analyst) performing overread and research of non-compliant members in HEDIS® quality measures. • Partner with the Operational Strategy & Oversight staff to set priorities and troubleshoot any issues that arise. • Monitor performance reports available of the Clinical Quality Analyst and provide remediation as needed. • 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 Skills • Management/ supervision experience • At least 1 year of HEDIS abstraction / medical record review experience is required. • Reliable hardwired high-speed internet access (no Wi-Fi) required. • Private US-based in-home office that follows HIPAA regulations required. • Clinical licensure - RN, LPN, LVN preferred but not required 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 http://russelltobin.com. Apply tot his job Apply To this Job

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