Molina Healthcare-posted about 1 year ago
$45,386 - $106,205/Yr
Full-time • Mid Level
Remote
251-500 employees
Insurance Carriers and Related Activities

The Sr. Abstractor for HEDIS/Quality Improvement at Molina Healthcare is responsible for conducting data collection and abstraction of medical records for HEDIS projects and related initiatives. This role involves ensuring productivity standards are met, mentoring entry-level abstractors, and participating in various meetings to enhance the quality of medical record reviews.

  • Conduct data collection and abstraction of medical records for HEDIS projects and supplemental data collection.
  • Coordinate and prepare for the HEDIS medical record review, including ongoing reviews of records submitted by providers.
  • Collect medical records and reports from provider offices as needed, and load data into the HEDIS application.
  • Compare documentation in medical records to specifications to verify the performance of preventive and diagnostic services.
  • Participate in meetings with vendors and teams regarding the medical record collection process and HEDIS review results.
  • Assist with projects and process improvement initiatives.
  • Mentor entry-level abstractors.
  • 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.
  • 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.
  • Competitive benefits and compensation package.
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