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 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 Apply To This Job Apply To This Job

Apply To This Job

Related roles

HEDIS Review Nurse - Remote - Contract

Remote · USA Full-time

Remote HEDIS Job at A-Line Staffing Solutions in Jersey City

Remote · USA Full-time

Program Manager- HEDIS

Remote · USA Full-time

Remote Outpatient CDI Specialist (RN)

Remote · USA Full-time

Remote Outpatient CDI Specialist (RN)

Remote · USA Full-time

RN – Case Management / Clinical Documentation Specialist (Remote) - RNCM 0608 IS#01

Remote · USA Full-time

Outpatient CDI Product Manager job at Solventum in Pittsburgh, PA

Remote · USA Full-time

[Hiring] RN-Clinical Documentation Specialist Lead @SSM Health

Remote · USA Full-time

Clinical Documentation Review Specialist

Remote · USA Full-time

[Hiring] RN – Case Management / Clinical Documentation Specialist @NavitasPartners

Remote · USA Full-time

Experienced Part-Time Remote Data Entry Specialist for arenaflex's E-commerce Operations

Remote · USA Full-time

Clinical Applications Specialist, Invasive Card...

Remote · USA Full-time

Assistant Program Manager for Veteran Mental Health Services

Remote · USA Full-time

Experienced Data Entry Clerk – Remote Work Opportunity with arenaflex

Remote · USA Full-time

Insurance/Claims Associate

Remote · USA Full-time

Shopify Developer (3+ Yrs) Performance, Maintenance & Big Edits (Contractor)

Remote · USA Full-time

Travel Advisor - Remote

Remote · USA Full-time

Experienced Remote Customer Service Representative – Delivering Exceptional Amazon Customer Experiences from the Comfort of Your Home

Remote · USA Full-time

Experienced Full Stack Data Entry Associate – Remote Database Management and Customer Service

Remote · USA Full-time

Experienced Part-Time Virtual Assistant – Data Entry Junior: Join arenaflex's Dynamic Team and Revolutionize Data Management

Remote · USA Full-time