Overreader, HEDIS/Quality Improvement (Remote)

Molina Healthcare • Long Beach, AZ

3d • Remote

About The Position

Molina's Quality Improvement Overread conducts oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The overreader team will meet chart overread productivity standards, minimum over read standards, and 2nd overread standards to ensure accuracy of their audit skills.

Requirements

• 3 years experience in healthcare
• Quality/HEDIS specific to medical record review and abstraction
• Bachelor's degree or equivalent experience

Nice To Haves

• At least 3 years of medical record abstraction experience
• 3+ years managed care experience.
• Advanced knowledge of HEDIS and NCQA
• Active RN license for the State(s) of employment

Responsibilities

• Performs the role of the HEDIS medical record review overreader/auditor which includes ongoing review of records reviewed and data entered by the abstraction team during the annual HEDIS medical record review as well as all other HEDIS/HEDIS like project.
• Participates in scheduled meetings with the Abstraction team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results.
• Provides feedback to providers on visit notes or feedback from the HEDIS audit.
• Makes recommendations based off of the audit and chart review.

Benefits

• Molina Healthcare offers a competitive benefits and compensation package.
• Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

What This Job Offers

• Job Type: Full-time
• Number of Employees: 5,001-10,000 employees