HEDIS Nurse Consultant

We are seeking a dedicated HEDIS Nurse Consultant to support our annual Healthcare Effectiveness Data and Information Set (HEDIS) reporting. This role involves abstracting medical record data, conducting medical record reviews, and ensuring compliance with HEDIS audit standards. The successful candidate will work remotely to perform claims research, prepare medical records for auditing, and communicate effectively with internal and external stakeholders.

• Abstract medical record data from practitioner’s files to support annual HEDIS reporting.
• Conduct medical record reviews to assist in annual reporting and address inquiries from providers and their office staff.
• Review and abstract 40-50 medical records per day based on NCQA and HEDIS technical specifications.
• Document information clearly and concisely from patient records into paper or electronic HEDIS applications.
• Ensure compliance with HEDIS audit and technical specification standards.
• Participate in training on NCQA requirements and complete Inter-Rater Reliability compliance.
• Communicate with stakeholders to gather additional medical information as needed.
• Comply with regulatory, accreditation, and internal guidelines.
• Stay current with standards relevant to the Quality Management team.
• Utilize internal systems and Microsoft Office for daily tasks.

• Active and Unrestricted RN License with 4 years of experience.
• Strong clinical background and understanding of medical terminology and healthcare practices.
• Experience in reviewing medical records and technical specifications to draw defensible conclusions.
• Experience in health insurance, healthcare, managed care, or a related setting.
• Excellent attention to detail and ability to accurately abstract HEDIS measures.
• Strong written and verbal communication skills.
• Ability to prioritize work independently and manage multiple assignments.
• Flexibility to adapt to changing requirements and technology platforms.
• Proficiency with Microsoft Office and Microsoft Teams.

• 2 years of experience in HEDIS abstraction and familiarity with HEDIS measure specifications.
• Experience in utilization management, quality management/review, accreditation, or outpatient clinic settings.

This is a 100% remote opportunity. Equipment, including a laptop and headset, will be provided. Candidates must have a high-speed internet connection, reliable phone, and a dedicated home office space. Work is typically conducted between 6 AM and 6 PM CST, Monday through Friday, with some flexibility after training. Training will occur virtually from 8 AM to 4:30 PM CST during the first week. Candidates must commit to working from February to May, with daily huddles and occasional schedule adjustments based on workload.

This is a Contract position based out of Des Moines, IA.

The pay range for this position is $40.00 - $45.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a fully remote position.

This position is anticipated to close on Jan 9, 2026.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $40 - $45