Senior Overreader, HEDIS/Quality Improvement (Remote)

Molina Healthcare • Roswell, NM • 3d 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

Restaurant Leader (Manager) Trainee

7-Eleven • Roswell, NM • 7h ago

Retail & Hospitality

Restaurant Leader (Manager) Trainee Apply Now ( https://my7elevenhr.wd12.myworkdayjobs.com/Careers/job/Store-42459-ROSWELL-NM/Restaurant-Leader--Manager--Trainee\R25\0000007443/apply ) Save Job Job ID R25_0000007443 Stor...

7h ago

Go to Apply

(USA) Personal Shopper - Sam's

Walmart • Roswell, NM • 4d ago

Position Summary... What you'll do... Develops and supports Membership by providing information on Membership benefits promoting the value of Company products and services processing Memberships upgrades and credit accou...

4d ago

Go to Apply

Finance Manager - REMOTE

Molina Healthcare • Roswell, NM • 1w ago

Finance, Accounting & Banking

JOB DESCRIPTION Job Summary Responsible for analysis of financial reports, trend, and opportunities. Includes evaluation of and recommendations relating to business opportunities, investments, financial regulations, and...

1w ago

Go to Apply

Manager, HCS Operations Support

Molina Healthcare • Roswell, NM • 1w ago

Management & Administrative

Job Description Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum...

1w ago

Go to Apply

Sr Digital Marketing Specialist (Remote)

Molina Healthcare • Roswell, NM • 1w ago

Sales & Marketing

Molina Healthcare is in search of an experienced Sr Digital Marketing Specialist. The Sr. Specialist, Digital Marketing will be responsible for analyzing and recommending improvements for digital marketing strategies, ex...

1w ago

Go to Apply

CDL A Shuttle Truck Driver

Sysco • Roswell, NM • 1w ago

Trucking & Construction

JOB SUMMARY Sysco has immediate job openings for dependable CDL A Shuttle Delivery Truck Drivers to safely and efficiently operate a tractor-trailer and transport doubles (potentially triples) between Sysco facility and...

1w ago

Go to Apply

Electrical

BiltWise Structures • Roswell, NM • 1w ago

IT & Engineering

----------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------...

1w ago

Go to Apply

Construction Laborer

BiltWise Structures • Roswell, NM • 1w ago

Trucking & Construction

** [ ]{#ctl00Maincontent_lblJobDescriptionValue} Veterans Preference: The Jobs for Veterans Act mandates priority of service to veterans seeking employment and training opportunities. To ensure compliance with this law,...

1w ago

Go to Apply

Assistant Restaurant Leader (Assistant Manager)

7-Eleven • Roswell, NM • 1w ago

Retail & Hospitality

Assistant Restaurant Leader (Assistant Manager) Apply Now ( https://olivia.paradox.ai/co/7Eleven60/Job?job\id=PAF-7E-04BE6F34-5B1B-488A-87D4-A468A61E0374\3448\1735340748\0 ) Save Job Job ID EARL42459 Store-ID 42459 Addre...

1w ago

Go to Apply

CDL-A - Tanker truck driver

Schneider • Roswell, NM • 1w ago

Trucking & Construction

Tanker truck driver Average pay: $1,310-$1,600 weekly Home time: Weekly Experience: All CDL holders Overview Haul food grade product in tanker trailers. 2-3 loads per week. Pay and bonus potential Mileage pay, plus hourl...

1w 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.