All roles

Senior Abstractor, HEDIS/Quality Improvement (Remote)

Remote · USA Full-time New today

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 REQUIRED EDUCATION: Bachelor's degree or equivalent experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

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

PREFERRED EXPERIENCE:

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

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: 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. Apply tot his job Apply To this Job

Related roles

RN, MDS Coordinator, LTC

Remote · USA Full-time

Clinical Documentation Specialist II – RN

Remote · USA Full-time

Site Care Partner/Lead CRA - FSP

Remote · USA Full-time

Associate Clinical Project Manager, Sponsor Dedicated

Remote · USA Full-time

Senior Clinical Research Associate/Clinical Research Associate II - Northeast, Southeast, Central US - FSP

Remote · USA Full-time

(Remote) Part-Time IRB Reliance Administrator - Office of Human Research Protections

Remote · USA Full-time

Home-Based Experienced CRA; Clinical Research Associate​/Equity

Remote · USA Full-time

Director, Institutional Review Board (remote)

Remote · USA Full-time

Sr CRA - FSP Oncology - California

Remote · USA Full-time

CRA II / Sr CRA - Sponsor Dedicated (Home-based - US)

Remote · USA Full-time

Experienced Customer Service Representative – Equipment Inspection and Maintenance

Remote · USA Full-time

Part-Time Financial Analyst – Merchant Revenue Analysis & Forecasting | Canada Division (Remote/Hybrid)

Remote · USA Full-time

Nurse Navigator, GPS High Risk, Full Time, Hybrid, FL

Remote · USA Full-time

Experienced Data Entry Clerk Wanted – Remote Work Opportunity for Skilled Typists with High-Speed Input

Remote · USA Full-time

Deployment Strategist (Palantir Foundry & AIP) - USA

Remote · USA Full-time

Experienced Customer Service Representative – Work from Home Opportunity at arenaflex

Remote · USA Full-time

Legislative Strategist - Oklahoma

Remote · USA Full-time

Head of Accounting / Controller

Remote · USA Full-time

[Hiring] Per Diem RN Telehealth After Hours - Kelsey-Seybold Clinic @UnitedHealth Group

Remote · USA Full-time

Experienced Part-Time Data Entry Specialist – Remote Opportunity at arenaflex

Remote · USA Full-time