Molina Healthcare

Compensation

Full Description

JOB DESCRIPTION Job SummaryProvides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. • Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. • Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. • Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. • Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. • Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. • Participates in and prepares feedback for meetings with vendors related to the medical record collection process. • Some medical records collection related travel may be required. Required Qualifications• At least 4 years of health care experience, including medical records support experience in a managed care setting, or equivalent combination of relevant education and experience. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. • Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. • Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). • Knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). • Proficiency with data analysis tools (e.g., Excel). • Excellent customer service and active listening skills. • Previous project coordination and/or process improvement experience. • Ability to effectively interface with staff, clinicians, and leadership. • Strong prioritization skills and detail orientation. • Strong verbal and written communication skills, including professional phone etiquette. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Registered Health Information Technician (RHIT). • Healthcare Effectiveness Data Information Set (HEDIS) data collection experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V