Job Description

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 IRED ED UCATION

Bachelor's degree or equivalent experience

REQU IRED E XPE RIENCE/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 EFE RRED E XPE RIENCE:

• At least 3 years of medical record abstraction experience
• 3+ years managed care experience.
• Advanced knowledge of HEDIS and NCQA

PR EFE RRED L ICENSE, CER TIFI CATIO N, AS SO CIATION

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.