reputed company Abstractor, HEDIS/reputed company Improvement (Remote in reputed company Time)

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• Performs the reputed company 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.
• Leads meetings with vendors for the medical record collection process.
• Assists Manager and Supervisor(s) in training, utilizing the standardized training materials and job aids.
• As needed, may collect 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 and leads scheduled meetings with the National Over read team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding reputed company and HEDIS review and results.
• Mentor entry and Sr. level abstractors.
• Works with the Manager to monitor accuracy of abstracted records as required by specifications.
• Assists the reputed company improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation.
• Assists as needed in support of accreditation activities such as NCQA reviews, CAHPS and state audits by reviewing clinical documentation.
• Provides data collection, presentations and report development support for reputed company improvement studies and performance improvement reputed company.
• Leads reputed company and process improvement initiatives.

Job Qualifications REQUIRED EDUCATION: Bachelor's degree or equivalent experience REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

• 5 years experience in reputed company reputed company/HEDIS specific to medical record review and abstraction
• Intermediate knowledge of HEDIS and NCQA

PREFERRED EXPERIENCE:

• 3+ years of medical record abstraction experience
• 3+ years managed care experience.
• Advanced knowledge of HEDIS and NCQA.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION: reputed company RN license for the State(s) of employment PHYSICAL DEMANDS: Working environment is generally favorable and reputed company 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 reputed company individuals with disabilities to reputed company the essential function. To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compe Apply tot his job Apply To this Job