HEDIS Abstraction Subject Matter Expert(Part-Time Consultant)Remote

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.

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.

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.

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

Time Commitment: 1 to 2 Hours per Day (Flexible)