Senior Abstractor, HEDIS/Quality Improvement (Remote)

Molina Healthcare

5d•$22 - $51•Remote

About The Position

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.

Requirements

Bachelor's degree or equivalent experience
3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction
Intermediate knowledge and understanding of HEDIS projects

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 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