QM Nurse Abstractor - Remote/Hybrid Temporary Assignment

Community Health Network of Connecticut, Inc. • Wallingford, CT

11d • Hybrid

About The Position

Community Health Network of Connecticut, Inc. (CHNCT) is currently seeking an experienced HEDIS® Nurse Abstractor. This is a remote/hybrid position and may require some travel within the state of Connecticut. Assignment is estimated to run February - April/May 2026.

Requirements

• Any combination of education and/or experience which would provide an equivalent background will be considered; registered nurse (RN), licensed professional graduate of an accredited school of nursing
• Requires a strong knowledge of HEDIS® technical specifications and NCQA health plan accreditation guidelines (minimum 1- 2 years).
• Excellent skill set for audit and abstraction of medical records
• Demonstrated knowledge and experience in managed care membership, provider, and/or hospital systems preferred.
• Candidates must have excellent computer skills and analysis capabilities, along with ability to log-on into multiple software as service tools.
• Knowledge of Microsoft office is required (proficient in Word, Excel, Outlook)
• Candidates must understand codes for services based on diagnosis and procedure based on HEDIS® Technical Specification requirements to support the overread process and validation of services as required.
• Must be research and detail oriented with the tenacity to find medical records and claim specific data for a specific measure within a given period.
• Requires effective written, oral, and interpersonal communication skills.
• Experience with Electronic Medical Record systems
• Candidate should reside in Connecticut

Responsibilities

• Candidate will work with the HEDIS ® team to conduct medical record abstraction reviews of records.
• Additionally, reviews require data analysis and research within data/claims systems, along with critical thinking skills as they will conduct research in a thoughtful and methodical search to locate specific claim information.
• Candidate will be able to apply the technical specifications to records in electronic systems and written records. All results will be entered into the certified HEDIS software platform.
• Candidates must work under the supervision of internal staff and designated lead to achieve goals and keep the project moving by adhering to measured productivity requirements. Module testing for HEDIS® specific measures may be required according to designated role.
• Candidate must pass a medical record abstraction test prior to starting actual record reviews. Must be flexible and willing to develop and share strategies to accomplish goals.
• Project is a timed study with tight deadlines that require high production/quality and staff committed to the entire season.

What This Job Offers

• Education Level: No Education Listed