← all jobs

Senior Abstractor, HEDIS​/Quality Improvement; Remote

Work from home Full-time role Hiring

Position Senior Abstractor, HEDIS/Quality Improvement (Remote) Job 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 collect medical records and reports from provider offices, load data into the HEDIS application, and compare 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.
  • Preference Experience At least 3 years of medical record abstraction experience; 3+ years managed care experience; advanced knowledge of HEDIS and NCQA.
  • Preference License, Certification, and Authorization Active RN license for the State(s) of employment. Benefits reputed company offers a competitive benefits and compensation package. Pay Range $25.1 - $48.94 / HOURLY. Actual compensation may vary based on geographic location, work experience, education and/or reputed company level. EEO Statement reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. #J-18808-Ljbffr Apply To this Job Apply To this Job

Apply To this Job

More open positions

Remote HEDIS Job at reputed company in Jersey City

Work from home Full-time role

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

Work from home Full-time role

CDI Specialist 2nd Level Reviewer- Remote

Work from home Full-time role

Clinical Documentation reputed company (CDI) Analyst (Remote)

Work from home Full-time role

RN Admissions & MDS Coordinator | Skilled Nursing | Hiring Incentives Available

Work from home Full-time role

Fractional CMO (Hands-On) – Cold Email, LinkedIn & Event Execution

Work from home Full-time role

Experienced Data Analyst – Unlocking Insights for careerzynith's Growth

Work from home Full-time role

Experienced Part-Time Remote Customer Service Representative – Walmart E-commerce Support

Work from home Full-time role

Experienced Full Stack Customer Conversation Specialist – Remote Customer Service and Support

Work from home Full-time role

Sales and Market Manager - Ohio Valley

Work from home Full-time role

Senior Specialist-Education

Work from home Full-time role

Remote Customer Service Representative – careerzynith – $30/hr – Flexible Schedule – Work‑From‑Home

Work from home Full-time role

Quality Management Specialist II

Work from home Full-time role

Copy Editor job at Aquent Talent in US National

Work from home Full-time role

Experienced Customer Service Representative – Remote Opportunity at careerzynith

Work from home Full-time role

Experienced Customer Care Representative – Deliver Exceptional Experiences with a Purpose-Driven careerzynith

Work from home Full-time role

Paralegal

Work from home Full-time role

Benefits and Absence Representative

Work from home Full-time role

Solution Sales Specialist, Publisher - IQVIA Digital

Work from home Full-time role

Sr Mgr, Medical Science Liaison, Community - Mid-Atlantic (MD, VA, NC, SC, GA)

Work from home Full-time role

Staff Accountant | US | Remote

Work from home Full-time role