Molina Healthcare Sr. Abstractor, HEDIS/Quality Improvement in San Antonio, Texas

Job Description

Job Summary Molina's Quality Improvement Sr. 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.

Knowledge/Skills/Abilities • Performs the lead role in 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. The Senior Abstractor will be asked to perform duties where clinical decision-making may be necessary. • Participates in meetings with vendors for the medical record collection process. • Assists Manager and Supervisor(s) in training and takes the lead role in these activities, utilizing the standardized training materials and job aids. • 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. • Works with the National Over read team to monitor accuracy of abstracted records as required by specifications. • Participates in scheduled meetings with the National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors.

Job Qualifications

Required Education Bachelor's degree or equivalent experience

Required Experience • Min. 3 years experience in healthcare with minimum 2 years experience in health plan quality improvement, managed care or equivalent experience.

Preferred Experience 2 years coding and medical record abstraction experience. • 1 year managed care experience. • Advanced knowledge of HEDIS and NCQA.

Preferred License, Certification, Association* 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.

Job: *Fusion

Organization: *Corporate

Title: Sr. Abstractor, HEDIS/Quality Improvement

Location: TX-San Antonio-TXBEXAR

Requisition ID: 1800898