All roles

Open role

Abstractor, National HEDIS /Quality Improvement (Remote)

Remote · Ghana Full-time

JOB DESCRIPTION Job SummaryProvides support for Molina enterprise quality improvement abstraction activities. Responsible for data collection and abstraction of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) and HEDIS-like initiatives and compliance, and supplemental data collection activities. Meets chart abstraction productivity standards and minimum overread standards. Essential Job Duties

  • Facilitates HEDIS medical record review, including ongoing review of records submitted by providers and the annual HEDIS medical record review process.
  • Participates in meetings with the national overread team, national quality training team, the regional HEDIS team, vendors and HEDIS auditors for quality/HEDIS review activities to coordinate medical records and quality-related initiatives.
  • Participates in meetings with vendors to enable the medical records collection process.
  • As needed, may collect medical records and reports from provider offices, load data into the HEDIS application, and compare documentation in the medical record to specifications to determine if preventive and diagnostic services have been correctly performed.

Required Qualifications

  • At least 2 years of experience in the health care industry, preferably in a quality-related role, or equivalent combination of relevant education and experience.
  • Basic knowledge and understanding of HEDIS and NCQA.
  • Attention to detail and organizational skills.
  • Ability to work independently in a fast-paced, deadline-driven environment.
  • Effective verbal and written communication skills.
  • Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications

  • Medical record abstraction experience.
  • Experience with HEDIS audits (including but not limited to chart collection, project management, etc.).
  • Managed care experience.
  • Intermediate knowledge related to HEDIS and National Committee for Quality Assurance (NCQA).
  • Registered Nurse (RN). If licensed, licensed must be active and unrestricted in state of practice. To all current Molina employees If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range $22.81 - $44.49 / HOURLY
  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Apply To this Job Apply To This Job

More open positions

Senior Abstractor, HEDIS/Quality Improvement (Remote)

Work from home Full-time role

[Remote] HEDIS Clinical Terminologist (Contract)

Work from home Full-time role

Senior Product Manager / Engineer - HEDIS SME

Work from home Full-time role

CDI Specialist 2nd Level Reviewer- Remote (Educator focused)

Work from home Full-time role

CDI Lead Specialist - Remote

Work from home Full-time role

Growth Marketing Specialist- EU

Work from home Full-time role

Clerk, Remote Testing

Work from home Full-time role

Global Customer Onboarding Strategist – B2B Advertising Solutions, Business Development & Client Success Lead (English)

Work from home Full-time role

Remote Data Entry Specialist - Online Job Opportunity for Students at careerzynith

Work from home Full-time role

Regional Sr. Manager Special Education

Work from home Full-time role

Illustrator - AI Trainer

Work from home Full-time role

Remote Senior Civil Engineer - Geotechnical

Work from home Full-time role

[Remote] Product Marketing Director, AI

Work from home Full-time role

Lead Front End

Work from home Full-time role

Remote Part‑Time Data Entry Specialist – careerzynith – $28/hr – Work‑From‑Home Opportunity

Work from home Full-time role

Computer Assisted Medical Coding Content Developer (Remote)

Work from home Full-time role

ICAM Automation Engineer (REMOTE)

Work from home Full-time role

Product Consultant (Ex Buying / Merchandising Director from high st fashion.)

Work from home Full-time role

Remote Customer Service Representative – Home‑Based Client Support Specialist at careerzynith – Flexible Hours, Career Growth & Competitive Benefits

Work from home Full-time role

Part-Time Data Entry Specialist – Remote Flexible Hours & Home‑Based Opportunities

Work from home Full-time role

Senior Associate I, Portfolio Analytics

Work from home Full-time role