All roles

Open role

Abstractor, National HEDIS /Quality Improvement (Remote)

Remote · Switzerland Full-time

JOB DESCRIPTION Job Summary Provides 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

More open positions

(Bilingual) Remote Travel Experience Designer

Work from home Full-time role

(Bilingual) Remote Travel Experience Designer

Work from home Full-time role

GTM Lead, India

Work from home Full-time role

Technical Project Engineer (BESS / Reciprocating Engines / LV / MV / Power Distribution Equipment)

Work from home Full-time role

Developer Senior Java& Kafka&Quarkus&React

Work from home Full-time role

Business Quantitative Analyst

Work from home Full-time role

Cloud Solutions Administrator

Work from home Full-time role

[Remote] Channel Partner Sales Engineer

Work from home Full-time role

Remote Podcast Editor – Mid-Senior Level

Work from home Full-time role

People Systems & AI Analyst

Work from home Full-time role

Product Developer (Ontario)

Work from home Full-time role

Site Reliability Engineer

Work from home Full-time role

Writer Mktg RFP

Work from home Full-time role

Segment Marketing Manager/AR (Remote)

Work from home Full-time role

Director of Diagnostics Business Development

Work from home Full-time role

Experienced Customer Support Specialist (Remote) - Deliver Exceptional Online Shopping Experiences at careerzynith

Work from home Full-time role

Senior Information Researcher – Retail Demand Forecasting & Pricing Analytics (Part‑Time, Remote) – careerzynith

Work from home Full-time role

[Remote] Senior Media Planner/Buyer

Work from home Full-time role

(Part-time Work From Home Jobs) Apple Remote Jobs

Work from home Full-time role

Junior Accounts Receivable Specialist job at Invicti Security in Austin, TX

Work from home Full-time role

Live Chat Customer Support Specialist – Remote Financial Services Client Experience & Satisfaction Champion

Work from home Full-time role