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.
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