Quality Improvement Abstractor
Posted on :
12-06-2024
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Job Description
Job Description:
Job Tittle: Quality Improvement Abstractor
Location: Remote
Duration: 8 Months (Possible Extensions)
Shift: 8AM 5PM (MonFri)
Walk me through the day to day responsibilities of this the role and a description of the project (Outside of Workday JD):
Completing HEDIS Medical record abstractions and overreads.
Describe the performance expectations/metrics for this individual and their team:
Individual Production
Retrievals 70/day
Abstractions 48/day
Overreads 60/day
Uploads (within 24 business hours) 15/hour
Faxcom Retrieval (within 24 business hours) 10/hour
Email Retrieval (within 24 business hours) 10/hour
MRO Retrieval (within 24 business hours) 15/hour
QSHR Outstanding and Unassigned (OU) Review 10/hour
Individual Quality
Individual Abstraction and Overread Accuracy 98%
Quality Rating Overall 98%
Quality Rating By Measure 98%
Position Purpose:
Lead data collection and abstraction for company quality measures including HEDIS CMS CHIPRA and/or any other custom measurements.
Education/Experience:
Associates degree in related field or equivalent experience. Bachelor degree preferred. 4 years of nursing medical assistant medical coding or data management experience. Experience in quality initiatives (including HEDIS project study analysis or NCQA standards) preferred. Advanced knowledge of Microsoft Applications including Excel and Access.
Licenses/Certifications:
Current states RN or LPN license preferred.
Responsibilities:
Assess vendordelegated 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 overreads
Communicate outcomes of abstraction and oversight activities with health plans and vendors when required
Perform other quality initiatives as necessary
Employment Type
Full Time
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