See all roles

Abstractor, National HEDIS /Quality Improvement (Remote)

Work from home Full-time role Hiring

JOB DESCRIPTION Job SummaryProvides support for Molina enterprise quality improvement abstraction activities. Responsible for data collection and abstraction of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) and HEDIS-like initiatives and compliance, and supplemental data collection activities. Meets chart abstraction productivity standards and minimum overread standards. Essential Job Duties

  • Facilitates HEDIS medical record review, including ongoing review of records submitted by providers and the annual HEDIS medical record review process.
  • Participates in meetings with the national overread team, national quality training team, the regional HEDIS team, vendors and HEDIS auditors for quality/HEDIS review activities to coordinate medical records and quality-related initiatives.
  • Participates in meetings with vendors to enable the medical records collection process.
  • As needed, may collect medical records and reports from provider offices, load data into the HEDIS application, and compare documentation in the medical record to specifications to determine if preventive and diagnostic services have been correctly performed.

Required Qualifications

  • At least 2 years of experience in the health care industry, preferably in a quality-related role, or equivalent combination of relevant education and experience.
  • Basic knowledge and understanding of HEDIS and NCQA.
  • Attention to detail and organizational skills.
  • Ability to work independently in a fast-paced, deadline-driven environment.
  • Effective verbal and written communication skills.
  • Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications

  • Medical record abstraction experience.
  • Experience with HEDIS audits (including but not limited to chart collection, project management, etc.).
  • Managed care experience.
  • Intermediate knowledge related to HEDIS and National Committee for Quality Assurance (NCQA).
  • Registered Nurse (RN). If licensed, licensed must be active and unrestricted in state of practice.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $22.81 - $44.49 / HOURLY

  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply To This Job

You might like

Registered Nurse (RN) – HEDIS Abstraction Specialist (Remote – Pennsylvania)

Work from home Full-time role

Bodily Injury Adjuster - Litigation & Homeowner Liability

Work from home Full-time role

Accounts Receivable (AR) Specialist - Healthcare Billing

Work from home Full-time role

Political Affairs Internship Part-Time in Worldwide - Remote Worldwide - Politic

Work from home Full-time role

[Hiring] Research Assistant @MPF Federal

Work from home Full-time role

VP of Finance (fully remote) | Restaurant Investment and Operating Platform

Work from home Full-time role

Remote Online EMDR Telehealth Therapist

Work from home Full-time role

Occupational Therapy Remote - New York

Work from home Full-time role

Physical Therapist - Full-Time or Part-Time - 100% Remote - PA License Required

Work from home Full-time role

Men's Virtual Pelvic Health Physical Therapist - Remote, Licensed in Virginia

Work from home Full-time role

Math 3 Tutors (Instant)

Work from home Full-time role

Senior Producer, Live Operations - Marvel Strike Force

Work from home Full-time role

Principal Cyber Threat Intelligence Researcher (Unit 42)

Work from home Full-time role

Experienced Data Entry Clerk – Entry-Level Opportunity for Career Growth and Development

Work from home Full-time role

[Remote] Business Development Representative (BDR)

Work from home Full-time role

Utilization Management Clinician - Independent Behavioral Health or Registered Nurse

Work from home Full-time role

Dental Verification Specialist-REMOTE at Wisdom Teeth Guys

Work from home Full-time role

Brand Owner Sales Representative

Work from home Full-time role

Experienced Chat Support Agent – Entry-Level Opportunity for Remote Work with arenaflex

Work from home Full-time role

Tired of Your Income Being Capped? Work from Home Opportunity

Work from home Full-time role