Registered Nurse (RN) – HEDIS Abstraction Specialist (Remote – Pennsylvania)

This is a remote position.

Seeking a detail-oriented and highly analytical Registered Nurse (RN) to join our team in a HEDIS Abstraction role, supporting critical healthcare quality initiatives across Pennsylvania. While the home office is based in Harrisburg, this position is fully virtual and open to candidates located anywhere within the state. This role offers a unique opportunity for experienced RNs who are looking to step away from bedside care and apply their clinical expertise in a focused, data-driven environment that directly influences patient outcomes and healthcare performance.

In this role, you will be responsible for reviewing and abstracting clinical data from medical records in accordance with HEDIS (Healthcare Effectiveness Data and Information Set) measures. You will analyze documentation related to preventive care, chronic disease management, and behavioral health services, ensuring all information is accurately captured and compliant with NCQA guidelines and measure specifications. Your clinical judgment and attention to detail will be essential in interpreting complex medical records and ensuring the integrity of reported data. 

You will utilize abstraction tools and electronic medical record systems to document findings while meeting strict productivity and quality benchmarks. This includes maintaining audit readiness, ensuring a high level of accuracy, and consistently meeting deadlines during peak reporting periods. The work you perform directly impacts healthcare quality scores, reimbursement, and public reporting, making your contribution vital to both patient care recognition and organizational success.

Collaboration is also a key component of this position. You will work closely with healthcare providers, health plans, and internal quality teams to resolve discrepancies and clarify documentation when needed. Simultaneously, the role offers a high level of independence, allowing you to manage your workflow in a structured remote environment while maintaining performance expectations. 

This position is ideal for Registered Nurses seeking greater flexibility, a predictable schedule, and the opportunity to leverage their clinical knowledge in a non-patient-facing role. It provides exposure to healthcare quality improvement, compliance, and population health, helping you build specialized skills that are highly valued across the healthcare industry.

Qualified candidates must hold an active RN license and have a strong understanding of medical terminology, clinical documentation, and healthcare data. Experience with electronic medical records and familiarity with coding systems such as ICD-10 and CPT are highly preferred. The ideal candidate is detail-driven, organized, and comfortable working independently in a fully remote environment while maintaining high standards of accuracy and productivity.