Clinical Quality Management Analyst - Registered Nurse (Remote)

Highmark Health

1 month ago

Pennsylvania — Remote$50.2K - $91.2KFull TimeAmbulatory Care Nursing

✓ No Call✓ No Weekends✓ No Nights

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Job Description

About the Role

Join Highmark Health as a Clinical Quality Management Analyst - Registered Nurse (Remote) in United States. Company: Highmark Inc. Job Description: JOB SUMMARY This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction for all product lines.

Key Responsibilities

CM codes to chronic conditions, and coordination with the revenue programs, credentialing and quality improvement programs to improve STARS, value

based care and achieve and maintain accreditation. Monitor changes, corrections and clarifications in applicable regulatory/accrediting body

Requirements

annual, and annual audits, identify gaps and communicate results. Conduct continuing education to providers on STARS, HEDIS, and HCC Coding. Conduct re

audits as needed Other duties as assigned or requested. EDUCATION Required Current state RN or LPN license or Bachelor’s degree in a Healthcare

related field Preferred 1 year of project management experience LICENSES OR CERTIFICATIONS Required Current State of PA RN or LPN licensure OR Current multi

developed, analytical and problem

Benefits & Compensation

Salary: $50.2K - $91.2K

Work Schedule

Full-Time position.

Remote position - work from anywhere.

Day shift only - no nights.

This position offers day shifts only. Work with Highmark Health in United States.

Key Skills

Quality ManagementProcess ImprovementMedical Record ReviewCodingData AnalysisHEDISICD 10-CM CodingComplianceEducationAuditingCommunicationProblem SolvingStatisticsMicrosoft OfficeCredentialingHealthcare

HealthcareManagement & LeadershipData & Analyticsvia Workday

Position Insights

Work-Life Balance Analysis

WeekdayDoc's proprietary algorithm rates Clinical Quality Management Analyst - Registered Nurse (Remote) at Highmark Health a 7.5 out of 10 for work-life balance — classified as very good. This places the position in the top 10% of all Ambulatory Care Nursing registered nurse listings evaluated on our platform. Contributing factors include no on-call duties, no weekend requirements, no night shifts, remote work flexibility.

Positions in this range offer a solid balance between clinical responsibility and personal time. Most providers report manageable workloads with adequate recovery time.

Ambulatory Care Nursing — Registered Nurse Career Context

This Ambulatory Care Nursing position at Highmark Health is open to registered nurse candidates.

Registered Nurses have diverse career pathways from bedside care to telehealth triage, care coordination, and leadership roles with increasingly flexible scheduling options.

Remote registered nurse positions in Ambulatory Care Nursing have grown significantly in recent years, offering clinicians the ability to maintain a full patient panel without geographic constraints or commute-related burnout.

Compensation Analysis

Highmark Health lists compensation for this registered nurse position at $50k to $91k annually.

Location & Logistics

This is a fully remote registered nurse position. Remote clinicians can practice from any state where they hold an active license, eliminating commute time and offering maximum schedule flexibility. Many remote healthcare positions also allow providers to establish a more sustainable long-term practice pattern.

Why This Position Stands Out

No on-call requirements — clinicians are completely off-duty after hours
No weekend shifts — preserving personal and family time
No night shifts — a daytime-only schedule
Fully remote — work from anywhere with an active license
Transparent compensation ($50k–$91k)

Skills, Responsibilities & Benefits

Key skills and qualifications: Quality Management, Process Improvement, Medical Record Review, Coding, Data Analysis, HEDIS, ICD 10-CM Coding, Compliance. Candidates with experience in these areas may be especially well-suited for this Ambulatory Care Nursing role.

Core responsibilities: The Clinical Quality Management Analyst will develop and manage process improvement initiatives, conduct audits, and provide education to providers on quality metrics. They will also analyze data to improve care and services for members.

About WeekdayDoc

WeekdayDoc is the only healthcare job board that scores every position for burnout risk and work-life balance. Every listing includes a proprietary burnout score, transparent salary data when available, and lifestyle filters for no-call, no-weekends, and remote positions. Browse more Ambulatory Care Nursing registered nurse jobs on WeekdayDoc to compare work-life balance scores and compensation across employers.