Sr. Abstractor, HEDIS/Quality Improvement (Remote in Pacific Time)

About the position

The Sr. Abstractor for HEDIS/Quality Improvement at Molina Healthcare is responsible for conducting data collection and abstraction of medical records for HEDIS projects and similar initiatives. This role involves ensuring productivity standards are met, mentoring entry-level abstractors, and participating in various quality improvement meetings and processes.

Responsibilities
• Coordinate and prepare for the HEDIS medical record review, including ongoing review of records submitted by providers.
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• Participate in meetings with vendors regarding the medical record collection process.
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• Collect medical records and reports from provider offices as needed, load data into the HEDIS application, and verify documentation against specifications.
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• Engage in scheduled meetings with the National Over read team, National Training Team, Regional HEDIS team, vendors, and HEDIS auditors to discuss quality and review results.
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• Assist with projects and process improvement initiatives.
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• Mentor entry-level Abstractors.

Requirements
• Bachelor’s degree or equivalent experience.
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• 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction.
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• Intermediate knowledge and understanding of HEDIS projects.

Nice-to-haves
• At least 3 years of medical record abstraction experience.
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• 3+ years managed care experience.
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• Advanced knowledge of HEDIS and NCQA.
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• Active RN license for the State(s) of employment.

Benefits
• Competitive benefits and compensation package.