HEDIS Abstraction Subject Matter Expert(Part-Time Consultant)Remote
hilabsNew York (NY)
HEDIS Abstraction Subject Matter Expert(Part-Time Consultant)Remote
Posted 4 days ago
hilabsNew York (NY)
SENIORITY
Lead
About the role
We are hiring experienced HEDIS Subject Matter Experts for a part-time remote consulting engagement with our Healthcare Product team.
This is an excellent opportunity for professionals who wish to continue their current full-time role while contributing their HEDIS expertise for 1 to 2 hours per day over the next 3 to 4 months.
Key Responsibilities: Provide HEDIS domain expertise to Product and Clinical teams.
Explain HEDIS measure logic and NCQA guidelines.
Review and validate HEDIS abstraction workflows.
Support Product, Engineering, and Data Science teams in implementing HEDIS measure logic.
Participate in discussions related to healthcare quality measures and workflow improvements.
Review AI-generated HEDIS abstraction outputs and provide domain feedback.
Required Skills: 3+ years of hands-on HEDIS experience.
Strong experience in HEDIS Abstraction.
Experience in Over-Read, PSV, Quality Review, and Medical Record Review.
Excellent understanding of NCQA HEDIS Technical Specifications.
Strong knowledge of numerator, denominator, exclusions, and measure logic.
Experience working across multiple HEDIS measures.
Good communication and problem-solving skills.
Preferred Skills: HEDIS SME or Team Lead experience.
Exposure to CMS Star Ratings or HCC.
Experience collaborating with Product, Clinical, or Engineering teams.
Experience reviewing AI-assisted abstraction outputs is an added advantage.
Engagement Details
Employment Type: Part-Time Consultant
Duration: 3 to 4 Months
Location: Remote
Time Commitment: 1 to 2 Hours per Day (Flexible)
Compensation: Best in the Industry
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