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 Apply To This Job

You might like

HEDIS Reviewer

Work from home Full-time role

Remote Outpatient CDI Specialist (RN)

Work from home Full-time role

CDI RN Specialist - Remote $10K Sign On Bonus

Work from home Full-time role

Clinical Documentation Improvement Specialist (CDI Specialist) - CDIP, CCDS, RN - Remote

Work from home Full-time role

CDI Outsourcing Manager - Remote (Solventum)

Work from home Full-time role

Registered Nurse Assessment Coordinator (RNAC / MDS Coordinator)-REMOTE FLEXIBILITY

Work from home Full-time role

MDS Coordinator - NO On-Call OR Weekend

Work from home Full-time role

MDS Nurse-Remote MI Licensed

Work from home Full-time role

Regional MDS Coordinator - Registered Nurse

Work from home Full-time role

MDS Coordinator - PART TIME; RN or LPN

Work from home Full-time role

Design Associate III

Work from home Full-time role

Senior Business Operations Manager - Live Games

Work from home Full-time role

Gen AI developer

Work from home Full-time role

Experienced Full Stack Enterprise Customer Engineer – Cloud AI Infrastructure Optimization

Work from home Full-time role

Vice President, Digital Sales Executive - Microsoft

Work from home Full-time role

Communication Studies Adjunct Faculty Pool

Work from home Full-time role

Senior Director, Clinical Supply & Supply Chain

Work from home Full-time role

Backend AI Software Engineer (all) - TypeScript / NodeJS

Work from home Full-time role

Remote Entry-Level Data Entry Clerk – Accurate Digital Records Management & Customer Support at arenaflex

Work from home Full-time role

[Remote] Senior Software Engineer, Mobile

Work from home Full-time role