Quality Improvement Abstractor

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Ideal Candidate

• Retrieve EMRs daily, pull medical records, and save to repository to support supplemental data.

• Engaged team player who contributes in meetings and discussions

• HEDIS quality abstraction experience (not risk abstraction)

• Able to give and receive feedback constructively, with a focus on process improvements

Position Purpose:
Lead data collection and abstraction for company quality measures, including HEDIS, CMS, CHIPRA and/or any other custom measurements.

• 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 over-sight activities with health plans and vendors when required
• Perform other quality initiatives as necessary
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience:
Associate’s 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.

Licenses/Certifications: Current state’s RN or LPN license preferred.

 

Pay Range: $26.50 - $47.59 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act