Job Description

Job Description

Terms of Employment:

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• Contract Duration: 5 months
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• Work Location: Primarily Remote (Hybrid focus for candidates residing in MD, DC, or VA). Requires mandatory on-site training in Meriwether, MD, the week of December 14th and occasional travel to provider sites.
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Overview:

Work with a leading healthcare organization as a Clinical Medical Review Nurse supporting the annual HEDIS retrospective project. In this role, you will drive medical record retrieval, abstraction, provider outreach, and quality measure management. Joining a collaborative and quality-focused team, you will play a critical role in evaluating medical records to ensure organizational compliance and high standards of care.

Key Responsibilities:

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• Conduct medical record retrieval, abstraction, pen management, and quality measure overreads for HEDIS retrospective projects.
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• Perform daily outreach to provider offices via phone, email, fax, and remote EMR portal access to request and secure medical records.
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• Conduct occasional local on-site visits to provider offices to retrieve paper records when necessary.
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• Complete comprehensive onboarding, orientation, and environment navigation virtual trainings during the first two weeks of assignment.
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• Utilize EMR systems (such as Epic, Athena) and internal software tools to review clinical documentation accurately.
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• Collaborate closely with quality managers and team members in a proactive, remote team environment.
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Required Qualifications:

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• Minimum 3 years of clinical background/experience combined with at least 5 years of recent HEDIS and quality measures experience (or 10 years of recent relevant HEDIS experience for candidates without a Bachelor's degree or RN/LPN license, such as CNAs, Medical Billers, or Coders).
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• Active RN, LPN, or CNA licensure/certification (Compact state licenses accepted).
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• Demonstrated experience in medical record retrieval, abstraction, and direct provider outreach.
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• Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint) and Microsoft Teams.
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• Reside within reasonable proximity to the MD/DC/VA area with willingness to travel locally to provider sites as needed.
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• Availability to attend mandatory, on-site, in-person training at the Meriwether office the week of December 14th.
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• Strict availability during the project blackout period from February through April (no extended planned vacations/absences).
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Preferred Qualifications:

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• Prior experience performing HEDIS overreads and high-level quality audits.
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• Familiarity with major EMR systems such as Epic and Athena.
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• Dual-monitor remote work setup established.
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