HEDIS Medical Record Review Project Nurse

Skip to main contentWe care about your privacyBy clicking "Accept All", you agree to the storing of cookies on your device to give you the most optimal experience using our website. We may also use cookies to enhance performance, analyze site usage and to personalize your experience.Read Full Privacy MessageDeclineAccept CookiesCareers at Elevance HealthEnglishSign InHEDIS Medical Record Review Project Nurse page is loadedHEDIS Medical Record Review Project NurseApplylocationsFL-TAMPA, 5411 SKYCENTER DR, STE 700 & 800time typeFull timeposted onPosted 7 Days Agotime left to applyEnd Date: August 17, 2026 (26 days left to apply)job requisition idJR195907Anticipated End Date:2026-08-17Position Title:HEDIS Medical Record Review Project NurseJob Description:HEDIS Medical Record Review Project NurseShift: Monday-FridayLocation: Virtual: Must live in FLThis role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. The HEDIS Medical Record Review Project Nurse will be responsible for HEDIS medical record identification and abstraction throughout the year.How you will make an impact:Serves as a resource and subject matter expert on HEDIS quality reviewer processesConducts over-reads on HEDIS records for compliance against HEDIS Technical SpecificationsEducates providers on HEDIS specifications and medical record documentation via various mediums such as HEDIS Encounter Portal Submission Tool, Hybrid Review Tool, HEDIS reference material development, and any other educational pieces for Provider relations, etcProvides feedback to providers via the HEDIS Encounter Submission Tool for medical records reviewed throughout the yearReviews HEDIS Encounter Portal submissions for Star Metrics throughout the calendar year with given set deadlinesWorks on projects as assignedDevelops expertise in the requirements and parameters of mandated HEDIS performance measures on an annual basisMinimum Requirements:Requires a BS in nursing and minimum of 2 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.Preferred Skills, Capabilities, and Experiences:Current, unrestricted clinical license appropriate to field of specialty (LPN/RN) as requiredActive state license requiredMinimum of 2 years of experience as a HEDIS medical chart reviewer preferredJob Level:Non-Management Non-ExemptWorkshift:1st Shift (United States of America)Job Family:MED > Licensed NursePlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.Who We AreElevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.How We WorkAt Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our...