← all jobs

Senior Abstractor, HEDIS​/Quality Improvement; Remote

Work from home Full-time role Hiring

Position: Senior Abstractor, HEDIS/Quality Improvement (Remote) 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 collect medical records and reports from provider offices, load data into the HEDIS application, and compare 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

  • Required

Education: Bachelor's degree or equivalent experience.

  • Required Experience/Knowledge, Skills & Abilities: 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction; intermediate knowledge and understanding of HEDIS projects.
  • Preference

Experience: At least 3 years of medical record abstraction experience; 3+ years managed care experience; advanced knowledge of HEDIS and NCQA.

  • Preference License, Certification, and Authorization:

Active RN license for the State(s) of employment.

Benefits

Molina Healthcare offers a competitive benefits and compensation package. Pay Range: $25.1 - $48.94 / HOURLY. Actual compensation may vary based on geographic location, work experience, education and/or skill level. EEO Statement Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #J-18808-Ljbffr Apply To this Job

More open positions

HEDIS Reviewer

Work from home Full-time role

Remote Outpatient CDI Specialist (RN)

Work from home Full-time role

CDI RN Specialist - Remote $10K Sign On Bonus

Work from home Full-time role

Clinical Documentation Improvement Specialist (CDI Specialist) - CDIP, CCDS, RN - Remote

Work from home Full-time role

CDI Outsourcing Manager - Remote (Solventum)

Work from home Full-time role

AI Voice Trainer - Punjabi

Work from home Full-time role

CSOT-Key Account Manager-Guangzhou

Work from home Full-time role

Account Manager Industrial Markets Region: Europe - Middle Eas

Work from home Full-time role

System Engineering - Azure

Work from home Full-time role

Remote Customer Service Representative – Full‑Time Virtual Support Role at careerzynith

Work from home Full-time role

SEO & AI Search Strategist

Work from home Full-time role

Growth Manager, SEM (International)

Work from home Full-time role

Network Management Specialist (Contract Specialist)

Work from home Full-time role

Sr CTA

Work from home Full-time role

Claims Auditor, Managed Care (remote)

Work from home Full-time role

Product Engineer, Global Manufacturing Engineering

Work from home Full-time role

Customer Service Associate – Multi‑Channel Support, Problem‑Solving & Customer Experience Specialist at careerzynith

Work from home Full-time role

Remote Real Estate Agent

Work from home Full-time role

Remote Customer Service Representative – Work From Home Opportunity with careerzynith (U.S. Based, Full-Time)

Work from home Full-time role

Polarion Administrator

Work from home Full-time role

Credentialing Specialist (REMOTE)

Work from home Full-time role