See all roles

Senior Abstractor, HEDIS​/Quality Improvement; Remote

Work from home Full-time role Hiring

Position: Senior Abstractor, HEDIS/Quality Improvement (Remote) 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 collect medical records and reports from provider offices, load data into the HEDIS application, and compare 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.
  • Preference

Experience: At least 3 years of medical record abstraction experience; 3+ years managed care experience; advanced knowledge of HEDIS and NCQA.

  • Preference License, Certification, and Authorization:

Active RN license for the State(s) of employment.

Benefits

Molina Healthcare offers a competitive benefits and compensation package. Pay Range: $25.1 - $48.94 / HOURLY. Actual compensation may vary based on geographic location, work experience, education and/or skill level. EEO Statement Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #J-18808-Ljbffr Apply tot his job Apply To this Job

You might like

Manager, Quality Performance and Outreach – STARS, CAHPS, PWP, HEDIS

Work from home Full-time role

Oncology - CAR-T - CRAs & Sr. CRAs - Remote US

Work from home Full-time role

Remote Insurance Agent

Work from home Full-time role

IRB Document Specialist I

Work from home Full-time role

Remote Insurance Agent

Work from home Full-time role

Remote Health Insurance Agent – Private Market (Work From Home, Commission-Based)

Work from home Full-time role

Accounts Payable Associate | Remote

Work from home Full-time role

Accounts Receivable Represenative II (Remote) - Fort Lauderdale, Florida, US

Work from home Full-time role

Senior Treasury Specialist

Work from home Full-time role

Collection Representative (Remote, Remote, US)

Work from home Full-time role

Territory Sales Engineer Associate

Work from home Full-time role

Customer Care Advocate - Spanish Speaking

Work from home Full-time role

Experienced Technical Support Associate I – Customer Care Specialist

Work from home Full-time role

Data Scientist II, Outcomes Research

Work from home Full-time role

Systems Engineer - Full time remote - based in India

Work from home Full-time role

Experienced Part-Time Amazon Customer Service Representative – Remote Work Opportunity

Work from home Full-time role

Experienced Customer Analytics Manager, Enterprise – Data-Driven Insights for arenaflex Customers

Work from home Full-time role

Senior Manager, Customer Success – Global Enterprise Partnerships & Strategic Growth Leader at arenaflex

Work from home Full-time role

Senior Program Manager (Direct Marketing, Non-Profit Fundraising)

Work from home Full-time role

Experienced Data Entry Specialist – Remote Opportunity with arenaflex

Work from home Full-time role