Abstractor, HEDIS /Quality Improvement (Remote)

Remote Full-time
Job Description

Job Summary

Molina's Quality Improvement Abstraction team functions to conduct 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.

Job Duties

Coordinates 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.

Job Qualifications

REQUIRED EDUCATION:

High School Diploma or equivalency

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

3 years experience in healthcare

Basic knowledge and understanding of HEDIS projects

PREFERRED EDUCATION:

Bachelor’s Degree

PREFERRED EXPERIENCE:

At least one year of medical record abstraction experience or 3-5 years experience with HEDIS audits (including but not limited to chart collection, project management, etc.)

1 year managed care experience.

Advanced knowledge of HEDIS and NCQA

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Active RN license for the State(s) of employment

STATE SPECIFIC REQUIREMENTS:

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

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: $20.29 - $46.42 / HOURLY
• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Molina Healthcare

Apply Now

Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Telecom (OSP) Construction Manager - REMOTE

Remote

Leadership Development Coordinator

Remote

[Remote] Human Resources Business Partner (HRBP) - Remote

Remote

[Remote] eBay Business Development Manager

Remote

Biomedical Engineer

Remote

Field Service Technician (Concord, NH)

Remote

**Experienced Customer Service Team Lead – Remote**

Remote

Experienced Data Entry Specialist for Digital Entertainment Platform – Remote Work Opportunity with arenaflex in UAE

Remote

Utilization Management Nurse Consultant

Remote

Business Development Client Executive, Insurance MGA

Remote
← Back