Sr. Abstractor, HEDIS/Quality Improvement (Remote)

Remote Full-time
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
Ā• 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.
Ā• Participates in meetings with vendors for the medical record collection process.
Ā• 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.
Ā• 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.
Ā• Assists with projects and process improvement initiatives
Ā• Mentors entry level Abstractors

Job Qualifications

REQUIRED EDUCATION:

Bachelor's degree or equivalent experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
Ā• 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction
Ā• Intermediate knowledge and understanding of HEDIS projects

PREFERRED EXPERIENCE:
Ā• At least 3 years of medical record abstraction experience
Ā• 3+ years managed care experience.
Ā• 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 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

**Experienced Home or Office Tele Chat Support Specialist – Delivering Exceptional Customer Experience in Behavioral Health Services**

Remote

**Experienced Customer Service Representative – Remote Work Opportunity at blithequark**

Remote

ESG and Sustainability Director – APi Group – New Brighton, MN

Remote

Personal PR & Branding Executive

Remote

CFSA - SeniorQuickBase Solutions Consultant/Developer - Rizeup Technology Training LLC

Remote

**Experienced Data Entry Clerk – Remote Work Opportunity with blithequark**

Remote

Specialty Account Manager, Sunosi (Rochester, NY)

Remote

Senior Program Manager - Healthcare Construction Projects (Remote)

Remote

Senior Product Manager, Payroll

Remote

Creative Director (Remote)

Remote
← Back