Hedis Abstractor
1 week ago
The San Francisco Health Plan (SFHP) is looking for a experienced HEDIS Abstractor as a Medical Record Review Overreader for our HEDIS (Healthcare Effectiveness Data and Information Set) pursuit project. The primary responsibilities of this position are 1) conducting quality control checks (overreads) of Abstractor medical record reviews based on HEDIS Rules of Abstraction and NCQA guidelines for hybrid measures to ensure the highest quality in our chart reviews, 2) conducting medical record reviews to identify whether quality of care measures were met by SFHP members 3) document chart review data into our HEDIS database tool. You will focus on HEDIS measures for Medicaid. The following degrees are relevant though not required; Registered Nurse (RN) Licensed Vocational Nurse (LVN), Medical Assistant, (MA) Registered Health Information Technician (RHIT).
HEDIS Medical Record Review Measures training and EHR training will be provided. You will be asked to be proficient in databases and conduct 100% of work activities on the computer.
This is a remote temporary position from approximately January 30, 2025 to May 13, 2025, 40 hours per week.
Salary: $50 per hour
WHAT YOU WILL DO:
- Review completed Abstractor chart reviews to validate Abstractor work and ensure compliance with HEDIS Rules of Abstraction and NCQA Guidelines
- Review assigned medical records to abstract clinical data elements for HEDIS reporting, e.g. results of laboratory tests, the most recent blood pressure reading, prenatal and postpartum care services, etc.
- Document abstraction findings into HEDIS database tool
- Communicate additional pursuit strategies for additional medical records, if needed, to other members of the team
- Integrate data collected from a variety of electronic and paper sources
- Communicate findings, including potential risk management issues promptly
- Provide written evaluation of data collection and data entry processes with ideas for improvement
WHAT YOU WILL BRING:
- Medical background (RN, RHIT, LVN or MA) or relevant experience
- 2+ years of experience with HEDIS Abstraction and Overreading
- Experience with an Electronic Health Record (EHR) systems
- Knowledge of ICD-9-CM, ICD-10-CM, CPT, and HCPCS coding conventions
ABOUT SFHP:
Established in 1997, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco County. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services.
San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
San Francisco Health Plan is an E-Verify participating employer.
Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.
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