HEDIS A Lucrative Option for Nurses

An Actalent article about the opportunities available to nurses that want new jobs

Nursing can be a tough gig — being on your feet for 12-hour shifts, working nights and weekends, dealing with patients’ endless needs. With such a high-stress, physically demanding job, it can easily make you feel burned out

If you’d like to get off the nursing floor, there’s an intriguing career option you may not have heard of: HEDIS nursing.

Instead of working directly with patients, HEDIS nurses review medical records to determine how well healthcare providers are caring for their patients. Some experienced nurses transition into this role looking for a change of pace because it’s well-paying seasonal work in an office setting.

To learn more about this little-known health care job, we spoke with Mike Pendergast, healthcare account manager who works closely with HEDIS nurses.

What is HEDIS?

The Healthcare Effectiveness Data and Information Set is a widely used set of performance measures in the managed care industry.

Every year, health insurance companies audit the hospitals and health practices where their customers get treatment. They want to see how effectively they are treating maladies ranging from heart attacks to diabetes to osteoporosis to broken bones. The annual effort tracks performance year after year to provide transparency and improve the quality of patient care.

What do HEDIS nurses do?

They collect and review data from patient charts and other medical records from hospitals, doctors’ offices and various health care providers to measure and help improve quality.

Who goes into HEDIS nursing?

Generally, HEDIS nurses are registered nurses or licensed practical nurses in the middle or later stages of their careers. These jobs require nurses because they’re authorized to review confidential medical records, and they have the expertise needed to make sense of the complex jargon.

“Some of these individuals are semi-retired,” Pendergast said. “They work from January to May, then do other things the rest of the year.”

Why do it?

Let’s start with the obvious: “The pay is pretty competitive,” Pendergast said. “Companies pay to attract talent for this role.”

Many who go into HEDIS nursing do it because they’re looking for a change. Often, they want to avoid burnout, and a 9-to-5 office job can start to look very appealing.

“Nurses want to help people. That’s why they chose that career,” Pendergast said. “But if you’ve been in a hospital for 10 years, working 12-hour shifts on the weekends, cleaning bedpans and dealing with sick patients, it can take a toll on you — physically, from being on your feet all day, but also emotionally, because you’ve seen a lot. You’ve seen people lose loved ones.”

What skills are needed?

Pendergast names two things a HEDIS nurse needs: a strong medical background and computer literacy.

Medical knowledge: Employers are looking for nurses with experience working in hospitals and writing medical records. You should have clinical knowledge needed to be able to look at a document and be understand what happened with a patient.

Computer literacy: You must have the skills necessary to go online, audit data and extract the important information from an electronic medical record.

Good people skills help. You may be contacting any number of health care providers asking them to send you important health records.

When do HEDIS nurses get hired?

HEDIS nursing is a seasonal job. The annual audits run from January to May, but staffing companies like Actalent start the hiring process well before that.

“We start recruiting for this in September even though they don’t start until January,” said Pendergast. “We start doing interviews in November. Decisions are made by the end of November, early December.

“If I’m a nurse looking to get into this, I’m not waiting until January.”

If HEDIS jobs are seasonal, what happens once they’re over?

Once their HEDIS work is finished in May, nurses have a number of options. It’s not hard for nurses to find new nursing jobs because of the low unemployment rate for nurses.

Some nurses return to work on a per diem basis, meaning employment at different hospitals on a day-to-day basis. This gives you more control over your schedule because you decide when you’re available.

Other HEDIS nurses get hired by a health insurer on a permanent basis.

“The HEDIS project gives you a foot in the door at insurance companies, which traditionally have more money and offer more competitive pay,” Pendergast said. “You can apply for similar roles like case management or utilization review, or disease management or behavioral health.”

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