Clinical Quality RN

Date Posted: 02/27/2026 Hiring Organization: Rose International Position Number: 497685 Industry: Insurance Job Title: Clinical Quality RN Job Location: Remote, USA Work Model: Remote Shift: 8am-5pm, EST or CST Employment Type: Temporary FT/PT: Full-Time Estimated Duration (In months): 3 Min Hourly Rate ($): 30.00 Max Hourly Rate ($): 30.00 Must Have Skills/Attributes: Clinical, RN Experience Desired: Two or more years of HEDIS/STAR experience (2 yrs); Registered Nurse (1 yrs) Required Minimum Education: Associate degree Required Certifications/Licenses: Registered NurseC2C is not availableJob Description JOB ID: 116227 Required Skills • Registered Nurse • Associate degree • Two or more years of HEDIS®/STAR experience • Three or more years of experience with data analysis/quality chart reviews • Must be able to review data and provide recommendations for improvement • Excellent communication practices, both oral and written • Experience using Microsoft Office applications, including databases, word-processing, and Excel® spreadsheets Desired Skills • Undergraduate degree • Certified Professional Coder • One or more years of process improvement experience • Experience in training and excellent presentation skills • Ability to be flexible in a continuously changing environment Job Duties • Support Chart Chase, Review and abstract medical record data into appropriate application(s). • Primary source verify abstracted medical record data. • Over read abstracted and verified medical record data. • Analyze chart data, evaluate for possible data integrity and/or data deficits and document findings. • Provide education and feedback to primary source verifiers and/or abstractors. • Support chart chase processes by requesting records from provider offices as needed. • Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures. • Support and improve communications between market and corporate departments. • Maintain education/knowledge base of HEDIS®/STARs standards and guidelines. • Assist with process improvement. • Performs all other related duties as assigned. Typical Day • Review and abstract medical records to support HEDIS and STAR measures. • Verify and audit chart data for accuracy and completeness. • Identify documentation gaps and provide recommendations for improvement. • Communicate with provider offices to obtain necessary records for chart chase activities. • Provide feedback and education to abstractors and verifiers to enhance data quality. • Collaborate with internal departments to ensure alignment between market and corporate teams. • Utilize multiple systems and Microsoft Office tools to document and report findings.Only those lawfully authorized to work in the designated country associated with the position will be considered.Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.Benefits: For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website. California Pay Equity: For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.

Created: 2026-03-04