United States onlyJob Summary
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.
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 Qualifications
REQUIRED EDUCATION:
Bachelor's degree or equivalent experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
- 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction
- Intermediate knowledge and understanding of HEDIS projects
PREFERRED EXPERIENCE:
- At least 3 years of medical record abstraction experience
- 3+ years managed care experience.
- Advanced knowledge of HEDIS and NCQA
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
Active RN license for the State(s) of employment
To 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.
