What are the responsibilities and job description for the Quality Improvement Abstractor position at Tennessee Health Plan?
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.
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
Education / Experience : Associate’s degree in related field or equivalent experience. A bachelor degree is preferred.
4 years of nursing, medical assistant, medical coding or data management experience is required. Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards)is preferred.
Advanced knowledge of Microsoft Applications, including Microsoft Excel and Access.
Licenses / Certifications : Current state’s RN or LPN license is 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. Total compensation may also include additional forms of incentives.
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
Salary : $27 - $48
