Job Description:

Job Tittle: Quality Improvement Abstractor

Location: Remote

Duration: 3 Months (Possible Extensions)

Shift: 8AM - 5Pm (Mon-Fri)

Walk me through the day to day responsibilities of this the role and a description of the project (Outside of Workday JD):

Morning HEDIS huddle to discuss work assignments and address any concerns
Review assigned workload chases
Ensure all entries and documentation is entered in vendor system for chart chase
Contact provider offices to inquire on charts not received
Check portal for potential quality of care concerns
Initiate chart audit and review if needed

Describe the performance expectations/metrics for this individual and their team:

Tell me about what their first day looks like:

Meet with Regina Everett Hiring Manager and Jeanette Walls HEDIS Project Manager to discuss the plan for the week and to ensure system accesses are requested

Must haves:

Must assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards
4+ years of nursing, medical assistant, medical coding, or data management experience is required.
Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards) 2.
Review medical records and abstract data for HEDIS and other measure sets in compliance with standards
Track and report on issues and outcomes related to abstractions and over-reads
Communicate outcomes of abstraction and over-sight activities with health plans and vendors when required
Perform other quality initiatives as necessary

Remote job, Shift work,