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HEDIS Data Reviewer

HEDIS Data Reviewer

Infojini IncPhiladelphia, PA, United States
1 day ago
Job type
  • Full-time
Job description

HEDIS Data Reviewer – Hybrid (Philadelphia, PA)

📍 Location : 200 Stevens Drive, Philadelphia, PA 19113

🕒 Schedule : Monday – Friday, 8 : 00 AM – 5 : 30 PM EST (Hybrid : 3 days onsite, some weekends as needed)

📅 Contract Duration : Dec 8, 2025 – Mar 15, 2026

💼 Department : Abstractions | Category : Non-Clinical (Nursing / Tech)

About the Role

We’re seeking experienced HEDIS Data Reviewers to join our Abstractions team in Philadelphia, PA. In this role, you’ll support our annual Healthcare Effectiveness Data and Information Set (HEDIS) and State EQRO reporting processes by performing medical record abstraction, quality review, and data validation.

You’ll play a vital part in improving patient care quality by ensuring data accuracy and compliance with HEDIS and state performance measure standards.

Key Responsibilities

  • Perform medical record abstraction and overreads following HEDIS and State Technical Specifications.
  • Coordinate medical record identification, collection, and review activities.
  • Accurately enter audit results using designated abstraction software tools.
  • Maintain a 98% abstraction proficiency rate and meet productivity standards.
  • Assist with medical record collection —including provider outreach via phone, fax, or mail.
  • Provide clinical and administrative support to providers as needed.
  • Stay current with HEDIS Technical Specifications and audit processes (PSV, CSV, MRRV).
  • Complete assigned special projects supporting Quality Reporting initiatives.

Required Skills & Experience

  • 3–5 years of experience working with HEDIS data, chart review, or data abstraction.
  • Strong understanding of HEDIS, QRS, and STARs programs.
  • Knowledge of medical terminology , chart components, and preventive health screenings.
  • Proficient in Microsoft Excel, Word, PowerPoint, and Outlook .
  • Experience with medical record abstraction tools (willingness to learn new systems).
  • Background in Pediatric, Maternity, Diabetic , or Provider Office settings preferred.
  • Familiarity with Cancer Registry and Bright Futures is a plus.
  • Strong organizational, critical thinking, and communication skills.
  • Ability to work independently and meet deadlines in a fast-paced environment.

    • Education

  • Associate Degree in Nursing or related field, or equivalent relevant experience.
  • RN or LPN license preferred but not required.

    • 💡 Why Join Us?

    You’ll contribute directly to quality improvement initiatives that shape better healthcare outcomes. If you’re passionate about data integrity, clinical excellence, and improving patient care quality—this role is for you.

    Apply Now to join a mission-driven team dedicated to advancing healthcare quality through accurate data and insight.

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    Data Hedis Data • Philadelphia, PA, United States