Senior Overreader, HEDIS/Quality Improvement (Remote)

Molina Healthcare • Yonkers, NY • 6h ago

Job Description

Job Summary

Molina's Quality Improvement Sr. Overreader 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. Sr. Overread team members will mentor new overread team members and assist with ad hoc projects.

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. Mentors entry-level Overreaders throughout the process.

Provides feedback to providers on visit notes or feedback from the HEDIS audit. Makes recommendations based off of the audit and chart review.

Assists with ad hoc projects.

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.

Job Qualifications

REQU IRED ED UC ATI ON :

Bachelor's degree or equivalent experience

REQU IRED E XPE RI EN CE/KNOWLEDGE, SKILLS & ABILITIES:

5 years experience in healthcare Quality/HEDIS specific to abstraction and overreading.

PR EFE RRED E XPE RI EN CE:

At least 3 years of medical record abstraction experience and at least 2 years experience in the overread role.

3+ years managed care experience.

Advanced knowledge of HEDIS and NCQA.

PR EFE RRED L IC EN SE, CE RTI FI CA TI ON , AS SO CI ATI ON :

Active RN license for the State(s) of employment

PHY SI CAL DEM AN DS :

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: $25.2 - $56.17 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Similar Jobs

Administrative Support for the Housing Litigation Division - Anti-Harassment Unit (HLD-AHU)

City of New York • New York, NY • 1h ago

Legal & Paralegal

Job Description About the Agency: The New York City Department of Housing Preservation and Development (HPD) promotes quality and affordability in the city's housing, and diversity and strength in the city's neighborhood...

1h ago

Go to Apply

Administrative Supervisor-FPA Operations

Mount Sinai Health System • New York, NY • 1h ago

Management & Administrative

Job Description The Administrative Supervisor is responsible for staff supervision and the coordination of specific business and administrative activities consistent with departmental objectives, administrative policies...

1h ago

Go to Apply

Administrative Specialist 1

New York State Civil Service • New York, New York • 1h ago

Management & Administrative

NY HELP Yes Agency People With Developmental Disabilities, Office for Title Administrative Specialist 1 Occupational Category Clerical, Secretarial, Office Aide Salary Grade 18 Bargaining Unit PS&T - Professional, Sc...

1h ago

Go to Apply

Administrative Law Judge

City of New York • New York, NY • 1h ago

Legal & Paralegal

Job Description NYC Department of Finance (DOF) is responsible for administering the tax revenue laws of the city fairly, efficiently, and transparently to instill public confidence and encourage compliance while providi...

1h ago

Go to Apply

Administrative Hearing Officer, Division of Adjudications

City of New York • New York, NY • 1h ago

Management & Administrative

Job Description About the Agency: The New York City Department of Housing Preservation Development (HPD) promotes quality and affordability in the city's housing, and diversity and strength in the city's neighborhoods be...

1h ago

Go to Apply

Administrative Coordinator - Rehabilitation and Human Performance

Mount Sinai Health System • New York, NY • 2h ago

Management & Administrative

Job Description The Administrative Coordinator is responsible for administrative and office service activities such as purchasing, payroll, records control and human resources for the head of a department, care center or...

2h ago

Go to Apply

Administrative Associate, Speed Reducers

City of New York • New York, NY • 2h ago

Management & Administrative

Job Description To be considered for this position, the candidate must be serving permanently in the civil service title of Principal Administrative Associate, or be reachable on the Principal Administrative Associate ci...

2h ago

Go to Apply

^Pharmacy 3rd Party Application Coordinator (Omnicell) - 5623120

Accenture • New York, NY • 2h ago

Hospital & Medical

Accenture Flex offers you the flexibility of local fixed-duration project-based work powered by Accenture, a leading global professional services company. Accenture is consistently recognized on FORTUNE's 100 Best Compan...

2h ago

Go to Apply

2026 Summer Intern: R&D (Undergrad and Grad)

PepsiCo North America Beverages • Valhalla, NY • 2h ago

Job DescriptionOverview Job Title: 2026 Summer Intern: R&D (Research & Development) InternPepsiCo is a playground for curious people. We invite thinkers, doers, and changemakers to champion innovation, take calcu...

2h ago

Go to Apply

2026 Summer Analyst Program, Early Careers - Corporate & Investment Banking (CIB) Chief Operating Office (COO)

Wells Fargo • New York, NY • 2h ago

Finance, Accounting & Banking

About this role: Wells Fargo is seeking talent to join the 2026 CIB COO Early Career Program in Corporate and Investment Banking. Learn more about the career areas and lines of business at wellsfargojobs.com ( https://ww...

2h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.