Quality Improvement Abstractor

$60,320 - $62,400/Yr

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Full-time - Entry Level

Remote

Professional, Scientific, and Technical Services

About the position

The Quality Improvement Abstractor plays a crucial role in enhancing patient care quality by analyzing healthcare processes, identifying improvement areas, and implementing effective solutions. This remote position requires a detail-oriented individual with a strong background in healthcare data abstraction, particularly in relation to HEDIS standards.

Responsibilities

• Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards.
• 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 oversight activities with health plans and vendors when required.
• Perform other quality initiatives as necessary.
• Complete training/testing on HEDIS measures with a required score of 95% to pass.
• Perform independent review of medical records and abstract and overread based on HEDIS measure standards.
• Apply critical thinking to utilize available resources and references during chart reviews.
• Attend meetings as required.

Requirements

• Texas LVN/RN license.
• Independent worker with critical thinking skills.
• Proficiency in computer applications.
• Previous HEDIS abstraction/overread experience.
• 3 years of experience in HEDIS (preferred).
• 4 years of experience in nursing, medical assistant, or medical coding (required).

Nice-to-haves

• Experience with MS Teams is preferred.
• Computer literacy is a must.

Benefits

• Dental insurance
• Health insurance
• Vision insurance