Medical Record Review Lead

4 weeks ago


Long Beach, California, United States Molina Healthcare Full time

Job Summary

Molina Healthcare seeks a skilled Medical Record Review Lead to join our team. As a key member of our Quality Improvement department, you will be responsible for conducting data collection and abstraction of medical records for HEDIS projects and other quality initiatives.

Key Responsibilities

  • Lead the coordination and preparation of HEDIS medical record reviews, ensuring timely and accurate completion of tasks.
  • Collaborate with vendors to collect and review medical records, and work with the National Over read team to monitor accuracy.
  • Develop and implement training programs for abstractors, and mentor junior team members to ensure successful project completion.
  • Participate in scheduled meetings with the National Over read team, National Training Team, and other stakeholders to discuss quality and HEDIS review results.
  • Assist with physician and member interventions, and provide data collection and presentation support for quality improvement studies and performance improvement projects.

Requirements

  • Bachelor's degree or equivalent experience.
  • 5 years of experience in healthcare Quality/HEDIS, with a focus on medical record review and abstraction.
  • Intermediate knowledge of HEDIS and NCQA.

Preferred Qualifications

  • 3+ years of medical record abstraction experience.
  • 3+ years of managed care experience.
  • Advanced knowledge of HEDIS and NCQA.

Working Environment

Molina Healthcare offers a competitive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V.



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