Back

Senior Abstractor, HEDIS/Quality Improvement (Remote)

Worldwide Salaried Open

Job Description

Job Summary Molina's Quality Improvement Sr. Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will meet chart abstraction productivity standards as well as minimum over read standards. Sr. Abstractors will also provide mentoring to entry level abstractors. Job Duties

  • Performs the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers and the annual HEDIS medical record review.
  • Participates in meetings with vendors for the medical record collection process.
  • As needed, may collects medical records and reports from provider offices, loads data into the HEDIS application, and compares the documentation in the medical record to specifications to determine if preventive and diagnostic services have been correctly performed.
  • Participates in scheduled meetings with the National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results.
  • Assists with projects and process improvement initiatives
  • Mentors entry level Abstractors

Job Qualifications REQU I RED ED U C A TI O N : Bachelor's degree or equivalent experience REQU I RED E X PE R I E N C E/KNOWLEDGE, SKILLS & ABILITIES:

  • 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction
  • Intermediate knowledge and understanding of HEDIS projects

PR E FE R RED E X PE R I E N C E:

  • At least 3 years of medical record abstraction experience
  • 3+ years managed care experience.
  • Advanced knowledge of HEDIS and NCQA

PR E FE R RED L I C E N S E, C E R TI FI C A T I O N , AS S O C I A TI O N : Active RN license for the State(s) of employment To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $19.64 - $42.55 / HOURLY

  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply tot his job Apply To this Job Apply tot his job Apply To this Job

More jobs

Intake Representative - Insurance Verification

Worldwide Salaried

[Hiring] Medical Virtual Assistant (Insurance Verification & Patient Coordination Specialist) @Virtual Rockstar

Worldwide Salaried

HEDIS Over Reader Nurse – Remote – Contract

Worldwide Salaried

Clinical Documentation Specialist (CDI) II – Remote, MI

Worldwide Salaried

Professional CDI Specialist - FT - Day - Physician Professional Coders Remote

Worldwide Salaried

In-patient hospitalist with CDI/coding background (Train AI Models Part Time!)

Worldwide Salaried

In-House CRA 2

Worldwide Salaried

MDS Coordinator-Lead (RN)

Worldwide Salaried

Clinical Research Associate I (West Coast: AZ, CA, NV, UT)

Worldwide Salaried

Registered Nurse Assessment Coordinator (RNAC / MDS Coordinator) REMOTE FLEXIBILITY

Worldwide Salaried

Sourcer

Worldwide Salaried

Experienced Full Stack Customer Support Agent – Live Chat and CRM Expertise

Worldwide Salaried

Experienced Live Chat Remote Representative – Disney Magic at Home

Worldwide Salaried

Training Lead-Truss

Worldwide Salaried

Spanish-Speaking Customer Support Roles Full Remote from Greece - Relocation

Worldwide Salaried

Experienced Remote Customer Service Representative – Food and Refreshment Group Pioneer

Worldwide Salaried

Frontend Engineer — San Francisco (Remote)

Worldwide Salaried

Experienced Customer Service Representative – Remote Work Opportunity at arenaflex

Worldwide Salaried

Experienced Customer Service Representative - Data Entry Clerk - Remote Work Opportunity with arenaflex

Worldwide Salaried

Experienced Work-From-Home Customer Service Representative – Delta Airline Support Team

Worldwide Salaried