Overreader, HEDIS/Quality Improvement (Remote)
Molina Healthcare Arizona; Mesa, Arizona; St. Petersburg, Florida; Idaho Falls, Idaho; Louisville, Kentucky; Houston, Texas; Bellevue, Washington; Racine, Wisconsin; Idaho; Kentucky; Michigan; Wisconsin; Columbus, Georgia; Nampa, Idaho; Milwaukee, Wisconsin; Nebraska; New Mexico; Tampa, Florida; Orlando, Florida; Des Moines, Iowa; Covington, Kentucky; Kearney, Nebraska; Yonkers, New York; Syracuse, New York; Fort Worth, Texas; West Valley City, Utah; Iowa; Washington; Utah; Jacksonville, Florida; Atlanta, Georgia; Augusta, Georgia; Meridian, Idaho; Sioux City, Iowa; Iowa City, Iowa; Grand Rapids, Michigan; Las Cruces, New Mexico; Rochester, New York; Dayton, Ohio; Dallas, Texas; Salt Lake City, Utah; Vancouver, Washington; Ohio; Texas; Miami, Florida; Ann Arbor, Michigan; Rio Rancho, New Mexico; Roswell, New Mexico; Phoenix, Arizona; Florida; Seattle, Washington; Caldwell, Idaho; Bowling Green, Kentucky; Warren, Michigan; Sterling Heights, Michigan; Grand Island, Nebraska; Omaha, Nebraska; Lincoln, Nebraska; Bellevue, Nebraska; Albuquerque, New Mexico; Buffalo, New York; Columbus, Ohio; Spokane, Washington; Layton, Utah; New York; Chandler, Arizona; Macon, Georgia; Boise, Idaho; Davenport, Iowa; Lexington-Fayette, Kentucky; Detroit, Michigan; Cincinnati, Ohio; San Antonio, Texas; Provo, Utah; Orem, Utah; Kenosha, Wisconsin; Madison, Wisconsin; Green Bay, Wisconsin; Scottsdale, Arizona; Savannah, Georgia; Cedar Rapids, Iowa; Owensboro, Kentucky; New York, New York; Santa Fe, New Mexico; Cleveland, Ohio; Akron, Ohio; Austin, Texas; Tacoma, Washington; Tucson, Arizona; Georgia Job ID 2029807
Job Description
Job Summary
Molina's Quality Improvement Overread conducts oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The overreader team will meet chart overread productivity standards, minimum over read standards, and 2nd overread standards to ensure accuracy of their audit skills.
Job Duties
- Performs the role of the HEDIS medical record review overreader/auditor which includes ongoing review of records reviewed and data entered by the abstraction team during the annual HEDIS medical record review as well as all other HEDIS/HEDIS like project.
- Participates in scheduled meetings with the Abstraction team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results.
- Provides feedback to providers on visit notes or feedback from the HEDIS audit. Makes recommendations based off of the audit and chart review.
Job Qualifications
REQUIRED EDUCATION:
Bachelor's degree or equivalent experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
• 3 years experience in healthcare Quality/HEDIS specific to medical record review and abstraction
PREFERRED EXPERIENCE:
- At least 3 years of medical record abstraction experience
- 3+ years managed care experience.
- Advanced knowledge of HEDIS and NCQA
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
Active RN license for the State(s) of employment
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting 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 enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.82 - $51.06 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 01/16/2025ABOUT OUR LOCATION
View Map- Sr Risk & Quality Performance Manager (Remote) Arizona, Roswell New Mexico, Orlando Florida, Grand Rapids Michigan, Owensboro Kentucky, Detroit Michigan, Albuquerque New Mexico, Dallas Texas, Tacoma Washington, St. Petersburg Florida, Savannah Georgia, Meridian Idaho, Des Moines Iowa, Sterling Heights Michigan, Idaho, Wisconsin, Bellevue Nebraska, Rochester New York, Columbus Ohio, Dayton Ohio, Fort Worth Texas, Layton Utah, Green Bay Wisconsin, Kenosha Wisconsin, Racine Wisconsin, Columbus Georgia, Lexington-Fayette Kentucky, Bowling Green Kentucky, Covington Kentucky, Warren Michigan, Florida, New Mexico, New York, Ohio, Seattle Washington, New York New York, Buffalo New York, Cleveland Ohio, San Antonio Texas, Vancouver Washington, Tucson Arizona, Mesa Arizona, Chandler Arizona, Augusta Georgia, Nampa Idaho, Sioux City Iowa, Louisville Kentucky, Iowa, Kentucky, Michigan, Texas, Omaha Nebraska, Syracuse New York, Milwaukee Wisconsin, Jacksonville Florida, Idaho Falls Idaho, Boise Idaho, Georgia, Utah, Kearney Nebraska, Las Cruces New Mexico, Akron Ohio, Salt Lake City Utah, Orem Utah, Spokane Washington, Madison Wisconsin, Scottsdale Arizona, Macon Georgia, Washington, Rio Rancho New Mexico, Santa Fe New Mexico, West Valley City Utah, Phoenix Arizona, Atlanta Georgia, Caldwell Idaho, Iowa City Iowa, Grand Island Nebraska, Lincoln Nebraska, Yonkers New York, Cincinnati Ohio, Austin Texas, Houston Texas, Provo Utah, Bellevue Washington, Miami Florida, Tampa Florida, Cedar Rapids Iowa, Davenport Iowa, Ann Arbor Michigan, Nebraska 01/16/2025
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- Overreader, HEDIS/Quality Improvement (Remote) Arizona, Mesa Arizona, St. Petersburg Florida, Idaho Falls Idaho, Louisville Kentucky, Houston Texas, Bellevue Washington, Racine Wisconsin, Idaho, Kentucky, Michigan, Wisconsin, Columbus Georgia, Nampa Idaho, Milwaukee Wisconsin, Nebraska, New Mexico, Tampa Florida, Orlando Florida, Des Moines Iowa, Covington Kentucky, Kearney Nebraska, Yonkers New York, Syracuse New York, Fort Worth Texas, West Valley City Utah, Iowa, Washington, Utah, Jacksonville Florida, Atlanta Georgia, Augusta Georgia, Meridian Idaho, Sioux City Iowa, Iowa City Iowa, Grand Rapids Michigan, Las Cruces New Mexico, Rochester New York, Dayton Ohio, Dallas Texas, Salt Lake City Utah, Vancouver Washington, Ohio, Texas, Miami Florida, Ann Arbor Michigan, Rio Rancho New Mexico, Roswell New Mexico, Phoenix Arizona, Florida, Seattle Washington, Caldwell Idaho, Bowling Green Kentucky, Warren Michigan, Sterling Heights Michigan, Grand Island Nebraska, Omaha Nebraska, Lincoln Nebraska, Bellevue Nebraska, Albuquerque New Mexico, Buffalo New York, Columbus Ohio, Spokane Washington, Layton Utah, New York, Chandler Arizona, Macon Georgia, Boise Idaho, Davenport Iowa, Lexington-Fayette Kentucky, Detroit Michigan, Cincinnati Ohio, San Antonio Texas, Provo Utah, Orem Utah, Kenosha Wisconsin, Madison Wisconsin, Green Bay Wisconsin, Scottsdale Arizona, Savannah Georgia, Cedar Rapids Iowa, Owensboro Kentucky, New York New York, Santa Fe New Mexico, Cleveland Ohio, Akron Ohio, Austin Texas, Tacoma Washington, Tucson Arizona, Georgia 01/16/2025
- Medical Assistant (Bilingual Required) - REMOTE Arizona, New York, Davenport Iowa, Lexington-Fayette Kentucky, Kearney Nebraska, Albuquerque New Mexico, Rio Rancho New Mexico, Akron Ohio, Dayton Ohio, Layton Utah, Racine Wisconsin, Atlanta Georgia, Caldwell Idaho, Iowa City Iowa, Louisville Kentucky, Omaha Nebraska, Lincoln Nebraska, Cincinnati Ohio, Green Bay Wisconsin, Tampa Florida, Utah, Bowling Green Kentucky, Grand Rapids Michigan, Sterling Heights Michigan, Santa Fe New Mexico, Cleveland Ohio, Fort Worth Texas, Spokane Washington, Bellevue Washington, Miami Florida, Orlando Florida, Idaho, Kentucky, Michigan, Macon Georgia, Ann Arbor Michigan, Rochester New York, Augusta Georgia, New Mexico, Florida, Boise Idaho, Des Moines Iowa, Cedar Rapids Iowa, Sioux City Iowa, Owensboro Kentucky, Grand Island Nebraska, Las Cruces New Mexico, New York New York, Columbus Ohio, Houston Texas, Austin Texas, West Valley City Utah, Kenosha Wisconsin, Chandler Arizona, Scottsdale Arizona, Jacksonville Florida, St. Petersburg Florida, Ohio, Nampa Idaho, Covington Kentucky, Roswell New Mexico, Yonkers New York, Provo Utah, Milwaukee Wisconsin, Madison Wisconsin, Phoenix Arizona, Mesa Arizona, Texas, Wisconsin, Savannah Georgia, Meridian Idaho, Idaho Falls Idaho, Detroit Michigan, Bellevue Nebraska, Buffalo New York, San Antonio Texas, Dallas Texas, Orem Utah, Columbus Georgia, Nebraska, Washington, Georgia, Iowa, Warren Michigan, Syracuse New York, Salt Lake City Utah, Tacoma Washington, Vancouver Washington, Tucson Arizona 01/10/2025
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