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Molina Healthcare: Sr. Abstractor, Hedis/Quality Improvement - Remote

Company: Molina Healthcare
Location: Long Beach
Posted on: October 15, 2020

Job Description:

Job DescriptionJob SummaryMolina's Quality Improvement Sr. Abstraction team functions to conduct 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.Knowledge/Skills/Abilities Performs the lead role in 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. The Senior Abstractor will be asked to perform duties where clinical decision-making may be necessary. Participates in meetings with vendors for the medical record collection process. Assists Manager and Supervisor(s) in training and takes the lead role in these activities, utilizing the standardized training materials and job aids. 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. Works with the National Over read team to monitor accuracy of abstracted records as required by specifications. Participates in scheduled meetings with the National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors.QualificationsJob QualificationsRequired EducationBachelor's degree or equivalent experienceRequired Experience Min. 3 years experience in healthcare with minimum 2 years experience in health plan quality improvement, managed care or equivalent experience.Preferred Experience 2 years coding and medical record abstraction experience. 1 year managed care experience. Advanced knowledge of HEDIS and NCQA. Candidates with clinical background are highly desirable.Preferred License, Certification, AssociationActive 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.

Keywords: Molina Healthcare, Long Beach , Molina Healthcare: Sr. Abstractor, Hedis/Quality Improvement - Remote, Other , Long Beach, California

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