HEDIS SEASON is coming.  HEDIS (Health Effectiveness Data Information Set) is a set of standardized performance measures designed to ensure:

• Consumers have the information needed to compare health plans.
• Health plans can identify opportunities for improvement.
• State and Federal regulators can maintain oversight of quality issues.

HEDIS is used by 90% of Medicare, Medicaid, and even private insurance companies to establish Star Rating with the Center for Medicare and Medicaid Services.   There are 95 HEDIS measures to be reviewed for HEDIS 2018. 

Hiring is going on now.  Training is usually right before the reviewing starts.  Companies are competing now for a limited number of experienced HEDIS applicants. 

HEDIS data is generally collected by two methods – onsite or remote.

(1) An onsite reviewer travels to a provider office to reviews charts.  Information is either printed or digitally downloaded.  On-site reviewers search medical records for specific information then either print or download it.     

(2) A remote reviewer uses a secure internet portal to access uploaded records.  Remote reviewers search for specific information, annotate it then record the information.

In a ten-minute online search this morning using HEDIS job postings in the past 30 days: 

• Indeed – 1640 openings – last year it was 1738 openings
• CareerBuilder – 236 openings – last year it was 254 opening
• Monster – 1000+ opportunities – this one only shows 1000
• Glassdoor – 246 openings – last year was 192 openings
• SimplyHired – 1528 openings – last year was 1574 opportunities
• Jobs.com – 1000+ - I guess they only display 1000 now – last year it was 2550 openings
• LinkedIn – 2731 openings – last year was 1536 opportunities

As you can see, the market is stable for HEDIS reviewers.  A CEO at a recruiting agency stated, “The demand is quickly out-numbering the qualified applicants.” 

So how do clinicians get a foot in the door?  Good question… I will have to research that.

Thank you for reading.  Watch for my next article on breaking into medical record reviewing.

About The Author