All roles

Open role

Senior Abstractor, HEDIS/Quality Improvement (Remote)

Remote · Australia Full-time

Job Description

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 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 REQU I RED ED U C A TI O N Bachelor's degree or equivalent experience REQU I RED E X PE R I E N C E/KNOWLEDGE, SKILLS & ABILITIES
  • 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction
  • Intermediate knowledge and understanding of HEDIS projects PR E FE R RED E X PE R I E N C E
  • At least 3 years of medical record abstraction experience
  • 3+ years managed care experience.
  • Advanced knowledge of HEDIS and NCQA PR E FE R RED L I C E N S E, C E R TI FI C A T I O N , AS S O C I A TI O N 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. Pay Range $19.64 - $42.55 / HOURLY
  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Apply To this Job Apply To this Job Apply To This Job

More open positions

Remote Data Entry Specialist – Content Cataloging & Metadata Management for a Global Streaming Entertainment Platform

Work from home Full-time role

HEDIS Over Reader Nurse – Remote – Contract

Work from home Full-time role

Experienced Data Entry Associate - Remote Position with Growth Opportunities at careerzynith

Work from home Full-time role

Empleo de Abstractor, HEDIS /Quality Improvement (Remote) en Molina Healthcare en Grand Island

Work from home Full-time role

Remote Data Entry Specialist – Entry-Level Opportunity with Comprehensive Training & Flexible Hours at careerzynith

Work from home Full-time role

Executive Assistant [Remote]

Work from home Full-time role

[Remote/WFM] Claims Analyst/Claims Adjuster (Remote)

Work from home Full-time role

Offensive Security Analyst II

Work from home Full-time role

[Remote] Staff Engineer - API & Data // The BOXOFFICE COMPANY

Work from home Full-time role

Experienced Data Entry Specialist – Remote Work Opportunity with careerzynith

Work from home Full-time role

Sr. Consultant, AI Strategy and Implementation

Work from home Full-time role

Admissions Counselor - Admissions - Welcome Center Services

Work from home Full-time role

Resilience Manager

Work from home Full-time role

[Remote] Site Reliability Engineer

Work from home Full-time role

[Remote] Technology Sales Support Specialist - Solution Consultant

Work from home Full-time role

Qualitative Testing Program Manager

Work from home Full-time role

Android Developer - AI Trainer

Work from home Full-time role

Senior Manager, Solution Engineering Enablement

Work from home Full-time role

Captioner/Transcriptionist

Work from home Full-time role

careerzynith Remote Content & Customer Experience Specialist – Entry‑Level Work‑From‑Home – Sales Enablement & UX Innovation

Work from home Full-time role

Steuerfachkraft (m/w/d) in Trogen mindestens 52.000€ - 100% Remote möglich

Work from home Full-time role