All roles

Senior Abstractor, HEDIS/Quality Improvement (Remote)

Remote · USA Full-time New today

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 tot his job Apply To this Job Apply tot his job Apply To this Job

Related roles

Intake Representative - Insurance Verification

Remote · USA Full-time

[Hiring] Medical Virtual Assistant (Insurance Verification & Patient Coordination Specialist) @Virtual Rockstar

Remote · USA Full-time

HEDIS Over Reader Nurse – Remote – Contract

Remote · USA Full-time

Clinical Documentation Specialist (CDI) II – Remote, MI

Remote · USA Full-time

Professional CDI Specialist - FT - Day - Physician Professional Coders Remote

Remote · USA Full-time

In-patient hospitalist with CDI/coding background (Train AI Models Part Time!)

Remote · USA Full-time

In-House CRA 2

Remote · USA Full-time

MDS Coordinator-Lead (RN)

Remote · USA Full-time

Clinical Research Associate I (West Coast: AZ, CA, NV, UT)

Remote · USA Full-time

Registered Nurse Assessment Coordinator (RNAC / MDS Coordinator) REMOTE FLEXIBILITY

Remote · USA Full-time

Experienced Customer Service Agent – Remote Opportunity with arenaflex

Remote · USA Full-time

Experienced Data Entry Specialist – Precision Data Management and Operational Support

Remote · USA Full-time

Math Teacher-Middle School (2026-2027 School Year)

Remote · USA Full-time

Experienced Work-from-Home Customer Support Associate – Delivering Exceptional Customer Experiences at arenaflex

Remote · USA Full-time

DSO Customer Success Manager- Cairo

Remote · USA Full-time

Senior Partnership Manager

Remote · USA Full-time

Experienced Customer Experience Concierge – Remote Chat Professional at arenaflex

Remote · USA Full-time

Financial Relationship Banker job at Huntington National Bank in Fraser, MI

Remote · USA Full-time

Experienced Full-Time Call Center Customer Service Representative – Remote Opportunity at arenaflex

Remote · USA Full-time

International Business Manager

Remote · USA Full-time