[Remote] Senior Abstractor, HEDIS/Quality Improvement (Remote)

Note The job is a remote job and is open to candidates in USA. Molina Healthcare is focused on improving healthcare quality, and they are seeking a Senior Abstractor for HEDIS/Quality Improvement. This role involves conducting data collection and abstraction of medical records for HEDIS projects, mentoring entry-level abstractors, and ensuring productivity standards are met.

Responsibilities

• 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 collects 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
• 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 Skills
• Bachelor's degree or equivalent experience
• 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction
• Intermediate knowledge and understanding of HEDIS projects
• At least 3 years of medical record abstraction experience
• 3+ years managed care experience
• Advanced knowledge of HEDIS and NCQA
• Active RN license for the State(s) of employment Benefits
• Competitive benefits and compensation package Company Overview
• Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals. It was founded in 1980, and is headquartered in Long Beach, California, USA, with a workforce of 10001+ employees. Its website is Company H1B Sponsorship
• Molina Healthcare has a track record of offering H1B sponsorships, with 56 in 2025, 45 in 2024, 43 in 2023, 31 in 2022, 35 in 2021, 55 in 2020. Please note that this does not guarantee sponsorship for this specific role. Apply To This Job