HEDIS Healthcare Consultant II (Fully Remote) 161806
A-Line Staffing is now hiring a Healthcare Consultant II in a Fully Remote position. Please contact Staffing Manager, Tiona Scroggins, at [email protected]. Assignment Dates: 1/5/2026 – 5/1/2026 Pay Rate: $31.80/hour Schedule: Monday – Friday, 8:00 AM – 5:00 PM (local time) Assignment Type: Temporary-to-Permanent (opportunity to extend or go permanent based on business needs) Work Environment: Fully Remote (100% work-from-home) Position Summary The Healthcare Consultant II participates in the audit and overread of the medical record collection and review process for HEDIS quality reporting. Training will be provided prior to the start of the assignment. This position involves auditing and interpreting clinical data through review of medical records, annotating via Adobe PDF, and auditing data within a collection tool to ensure compliance with HEDIS and CMS performance measures. The consultant ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation standards. This is a computer-based, non–patient-facing role that requires excellent analytical skills, attention to detail, and strong familiarity with medical terminology and record review.
Key Responsibilities
- Audit data entered into the system based on HEDIS MY 2020 Technical Specifications.
- Review and interpret clinical information from medical records.
- Annotate medical records accurately using Adobe PDF.
- Identify trends and document opportunities for process improvement.
- Maintain productivity levels while meeting accuracy requirements for abstraction and data entry.
- Ensure compliance with HIPAA Privacy and Security Rules and safeguard all Protected Health Information (PHI).
- Attend all required training sessions and conference calls for the project.
- Return company equipment in good condition at the end of the project.
Required Qualifications
- Minimum of 5 HEDIS seasons of experience reviewing medical records is required.
- Prior chart audit experience is strongly preferred.
- Must have strong medical terminology knowledge and the ability to interpret medical records.
- Proven ability to prioritize tasks, maintain accuracy, and meet project deadlines.
- Strong analytical, problem-solving, and investigation skills.
- Professional demeanor, solid work ethic, and commitment to confidentiality.
- Excellent written and verbal communication skills.
- Computer proficiency required, including:
- Microsoft Word, Excel, and Outlook (must list 3 programs and years of experience).
- Adobe Acrobat Reader and file management (e.g., saving files to folders).
- Must have a verifiable High School Diploma or GED.
- Must be able to work the required schedule Monday through Friday, 8 AM – 5 PM local time without interruption during the assignment period (January–May).
Preferred Qualifications
- RN or LVN encouraged to apply
- Successful prior HEDIS review experience may be accepted in place of licensure.
Technical & Home Office Requirements
- Must connect company-issued laptop directly to the home internet modem via ethernet cable (Wi-Fi not permitted).
- Must have a secure, private workspace suitable for confidential work.
- 100% of job duties will be completed on a computer.
Additional Information
- Type of Start: Class with a set start date.
- Environment: Fully remote, non–patient-facing.
- Program Area: Aetna HEDIS.
#INDKS Job Types: Full-time, Contract Pay: $31.80 per hour Expected hours: 40 per week Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Application Question(s):
- How many years or season of HEDIS experience do you have?
- Do you have experience as a HEDIS Abstractor, Overreader, Auditor or all three?
- Is your HEDIS experience on your resume or do you agree to update it if considered for an interview?
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