HEDIS Registered Nurse, NY, NY

Position Summary
The Clinical Quality Temp is responsible for performing Healthcare Effectiveness Data and Information Set (HEDIS) medical record review, data abstraction, and clinical data quality activities using internal and external clinical data sources. This role supports the accurate, Timely, and compliant collection of clinical data for HEDIS reporting, regulatory submissions, and quality improvement initiatives.
Office location: 100 Church Street, New York, NY

Essential Duties and Responsibilities
• Performs HEDIS medical record review, abstraction, data entry, and validation activities in accordance with NCQA guidelines and organizational policies.
• Reviews and validates clinical documentation and coding from electronic medical records (EMRs), provider records, vendors, and other clinical data sources.
• Ensures the accuracy, completeness, and integrity of HEDIS data used for regulatory reporting and quality improvement initiatives.
• Maintains compliance with NCQA, CMS, state, and organizational standards and requirements.
• Prepares and maintains productivity reports, documentation tracking, and compliance findings.
• Additional duties as necessary and as directed.

Minimum Qualifications

• Registered Nurse (RN)
• Minimum of one (1) year of experience in healthcare quality, HEDIS operations, medical record review, data abstraction, or healthcare analytics required.

Knowledge, Skills, and Abilities

• Working knowledge of HEDIS measures, clinical documentation standards, and healthcare quality programs.
• Knowledge of ICD-10, CPT, HCPCS coding, and medical terminology.
• Strong attention to detail with the ability to manage multiple priories in a fast-paced environment.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office Suite, including Excel and Outlook.
• Ability to work independently and meet strict deadlines

Preferred Qualifications

• Background in health care or managed care.
• Experience with a health plan's quality improvement/management department
• Two (2) or more years of experience in Managed Care, Health Insurance, or Quality Improvement.
• Knowledge of NCQA HEDIS specifications, STAR, and QARR quality programs.
• Prior experience with HEDIS abstraction, chart review, audit support, or medical record validation.

Duration: 3-6 Months Mon - Fri: 8:30am to 5:00pm (100 Church Street: Tuesday, Wednesday, Thursday)