Lead Abstractor, HEDIS/Quality Improvement (Remote)

About the position The Lead Abstractor for HEDIS/Quality Improvement at Molina Healthcare is responsible for conducting data collection and abstraction of medical records for HEDIS projects and related initiatives. This role involves leading a team of abstractors, ensuring compliance with productivity and quality standards, and collaborating with various stakeholders to enhance the quality of healthcare data and improve overall project outcomes. Responsibilities • Coordinate and prepare for the HEDIS medical record review, including ongoing review of records submitted by providers. , • Lead meetings with vendors for the medical record collection process. , • Assist Manager and Supervisor(s) in training abstractors using standardized training materials. , • Collect medical records and reports from provider offices as needed, loading data into the HEDIS application and verifying documentation against specifications. , • Monitor accuracy of abstracted records in collaboration with the National Over read team. , • Participate and lead meetings with various teams and vendors regarding quality and HEDIS review results. , • Mentor entry and senior-level abstractors. , • Support quality improvement staff with physician and member interventions through medical record reviews. , • Assist in accreditation activities such as NCQA reviews and state audits by reviewing clinical documentation. , • Provide data collection, presentations, and report development support for quality improvement studies. Requirements • Bachelor's degree or equivalent experience. , • 5 years of experience in healthcare Quality/HEDIS specific to medical record review and abstraction. , • Intermediate knowledge of HEDIS and NCQA. Nice-to-haves • 3+ years of medical record abstraction experience. , • 3+ years of managed care experience. , • Advanced knowledge of HEDIS and NCQA. , • Active RN license for the State(s) of employment. Benefits • Competitive benefits and compensation package. Apply Job! Apply to this Job