Job Description
**Job Description**
**Job Summary**
Molina's Quality Improvement Abstraction team functions to conduct 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.
**Job Duties**
+ Coordinates 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.
**Job Qualifications**
**REQUIRED EDUCATION:**
High School Diploma or equivalency
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:**
+ 3 years experience in healthcare
+ Basic knowledge and understanding of HEDIS projects
**PREFERRED EDUCATION:**
Bachelor's Degree
**PREFERRED EXPERIENCE:**
+ At least one year of medical record abstraction experience or 3-5 years experience with HEDIS audits (including but not limited to chart collection, project management, etc.)
+ 1 year managed care experience.
+ Advanced knowledge of HEDIS and NCQA
**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:**
Active RN license for the State(s) of employment
**STATE SPECIFIC REQUIREMENTS:**
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
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: $22.81 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Job Tags
Hourly pay, Work experience placement, Work at office, Remote work,
Similar Jobs
Champion Specialty Services Corp.
...DESCRIPTION As an Environmental Operator/Technician ( ie CDL Driver), you will be provided with the state-of-the-art equipment to... ...Safely operate a variety of equipment including hydro-vac, vacuum trucks, guzzlers, roll-off trucks, box trucks and other equipment as...
Sanmina
...sectors. Sanmina Corporation has facilities strategically located in key regions throughout the world. Specializing in precision machining and metal fabrication, our Sanmina Newark, California facility has 16 years experience in both precision and large format...
WorkSource Oregon
...ELD). - Load/unload products using an electric pallet jack. - Deliver fresh, high quality produce and grocery products using a box truck to local businesses while providing top-tier customer service in each interaction. - Collect payments from COD customers and...
Outlier AI
Join a global community of talented professionals to shape the future of AI. Earn up to $15 USD/hr and additional rewards based on quality of submission. Outlier is committed to improving the intelligence & safety of AI models. Owned and operated by Scale AI , weve ...
Insero Talent Solutions
...activities Lead, coach, and supervise on-site staff, including leasing, maintenance, and administrative personnel Establish... ...years of residential property management experience (market-rate apartment experience strongly preferred) Proven ability to manage large...