Job Details

ID #52858619
State New Mexico
City Usnm
Full-time
Salary USD TBD TBD
Source Molina Healthcare
Showed 2024-11-09
Date 2024-11-10
Deadline 2025-01-09
Category Et cetera
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Sr. Abstractor, HEDIS/Quality Improvement (Remote)

New Mexico, Usnm 00000 Usnm USA
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Job DescriptionJob SummaryMolina'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 QualificationsREQU I RED ED U C A TI O N :Bachelor's degree or equivalent experienceREQU 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 employmentTo 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: $26.19 - $51.06 / HOURLYActual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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