Clinical Validation RN

• Posted 3 hours ago • Updated 3 hours ago
Full Time
Fitment

Dice Job Match Score™

🔢 Crunching numbers...

Job Details

Skills

  • Mapping
  • Reasoning
  • Training
  • Evaluation
  • Nursing
  • HEDIS
  • Documentation
  • Artificial Intelligence
  • Workflow
  • Healthcare Information Technology
  • Health Care
  • Life Sciences
  • Recruiting

Summary

Healthcare IT Leaders is seeking a Registered Nurse (RN) for a 6-month+ contract opportunity with potential for extension. This position is fully remote and will support HEDIS clinical validation and AI-assisted gap closure review.

Contract: 6+ months with potential for extension

Location: Fully Remote

Schedule: Monday-Friday, 40 hours/week, EST business hours

Responsibilities:
  • Review HEDIS gap closures by interpreting measure requirements, evaluating AI/model reasoning, and validating supporting clinical evidence
  • Approve, deny, or escalate gap closures based on clinical judgment and established HEDIS guidelines
  • Validate extracted clinical concepts and codes, including diagnoses, medications, labs, vitals, and procedures, to ensure accurate mapping
  • Identify coding, clinical concept, or documentation errors before they impact HEDIS and risk-adjustment submissions
  • Clearly document the clinical reasoning behind validation decisions to support ongoing model training and evaluation
  • Assist with calibrating confidence thresholds and expanding the types of cases that can be accurately validated through AI-assisted workflows

Requirements:
  • Active Registered Nurse (RN) license required; Compact/Multistate RN license required
  • 2+ years of experience in clinical nursing, HEDIS/quality, clinical validation, or a related healthcare setting
  • Strong clinical judgment and ability to interpret clinical documentation, diagnoses, medications, labs, procedures, and quality measures
  • Comfortable working with technology and AI-assisted clinical workflows


To learn more about this and other positions, contact Julie Easley at or . Healthcare IT Leaders is a national leader in IT workforce solutions, connecting healthcare provider, payer and life sciences organizations with experienced technology talent for consulting and full-time hiring. For more information, visit us on the web at .

#LI-JE1
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 10358453
  • Position Id: 032994
  • Posted 3 hours ago
Create job alert
Set job alertNever miss an opportunity! Create an alert based on the job you applied for.

Similar Jobs

No location provided

Today

Full-time

USD 35.00 - 65.00 per hour

No location provided

Today

Full-time

USD 35.00 - 65.00 per hour

Remote

Today

Full-time

USD 150,000.00 - 178,000.00 per year

New York, New York

Today

Full-time

USD 70,000.00 - 80,000.00 per year

Search all similar jobs