Supervisor, Medical Records QA (2502BR) Long Beach, California

Molina Healthcare - Supervisor, Medical Records QA

Job SummaryThe Supervisor will work with the manager of MRR Quality in setting medical records review standards that are to be applied to individual health plan and vendor projects.

Essential Functions

• Works with the Manager of Quality to set medical records review (MRR) standards for HEDIS for quality assurance purposes; assist with writing P&Ps to document standards for review by external reviewers
• Supervises staff in HEDIS MRR QA unit
• Conduct training and develop coaching plan for HEDIS MRR QA for Molina Corporate and Molina health plans
• Responsible for HEDIS reporting software’s MRR module and uses or modifies to meet Molina’s quality assurance goals
• Conduct pre-project testing and on-going monitoring of all enterprise MRR staff to ensure compliance against MRR standards
• Ensurs compliance with MRR standards of the HEDIS Compliance Audits
• Is able to meet all deadlines as prescribed by internal timelines and timelines set by external stakeholders such as the National Committee for Quality Assurance and the organization’s HEDIS Compliance Auditor
• Other duties, as assigned

Knowledge/Skills/Abilities• Has knowledge of HEDIS, risk adjustment, medical records review collection and abstraction concepts, quality assurance concepts, including advanced skills like inter-rater reliability and sampling for QA purposes, and general quality improvement principles
• Demonstrated progress in teaming and interpersonal skills, and the ability to initiate and maintain cross-team relationships
• Demonstrated ability to meet mission-critical deadlines and to motivate staff to meet these deadlines; proven ability to manage personal stress and those of staff through proactive management and emotional intelligence skills
• Proven project management skills, including the ability to manage people and time resources and the ability to monitor the effectiveness of activities
• Solid organizational skills and leadership
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
• Excellent verbal and written communication skills
• Ability to abide by Molina’s policies
• Maintain regular attendance based on agreed-upon schedule
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

 



Required Education:
BA/BS/BSN or equivalent

Required Experience:
• Minimum of 2 years of experience in HEDIS medical records collection and abstraction
• 2+ years of medical record review experience

Required Licensure/Certification/Associations:

N/A

Preferred Education:
Clinical degree highly preferred, including, but not limited to, RN, LVN, CCC, MA, RHIT, EMT, LCSW
Preferred Experience:
• Experience in health plan operations or health plan quality
Preferred Licensure/Certification/Associations:
CPHQ



Molina Healthcare, a FORTUNE 500 company that is nationally recognized and has grown into one of the leaders in providing quality healthcare for financially vulnerable individuals and families. Molina Healthcare is a multi-state healthcare organization with flexible care delivery systems focused exclusively on government-sponsored healthcare programs for low income families and individuals. Currently, Molina Healthcare arranges for the delivery of healthcare services or offers health information management solutions for nearly 4.3 million individuals and families who receive their care through MedicaidMedicare and other government funded programs in 15 states. We continually seek talented individuals who share our values and can contribute to our mission of providing the highest quality health care to those who need it most and are least able to afford it. Become part of the Molina Healthcare family today! Discover extraordinary opportunities for growth.

 

Molina Benefits

Molina offers a variety of career opportunities across the nation as well as excellent compensation and an attractive benefits package that includes.

·   Medical

·   Dental

·   Vision

·   Short- and long-term disability

·   Flexible spending accounts

·   Life insurance plans

·   401(k) savings plan with employer match

·   Paid time off

·   Paid holidays

·   Volunteer time off

·   Tuition reimbursement

·   Referral bonuses and more! 


To all current Molina employees if you are interested in applying for this position please apply through the intranet job listing. Also, fill out an Employee Transfer Request Form (ETR) and attach it to your profile when applying online.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

To apply, please click here