Presbyterian Healthcare Services · 15 hours ago
Senior Quality Improvement Abstract
United States
Full-time
Remote
Mid, Senior Level
$51K/yr - $78K/yr
1+ years expPresbyterian Healthcare Services is hiring a skilled Senior Quality Improvement Abstract to join their team. The role involves overseeing medical record retrieval and reporting processes to support various health management initiatives and regulatory reporting.
AssociationHealth Care
Responsibilities
Oversees and performs the Medical Record Retrieval, Review and Reporting process to support HEDIS, STARs, HEDIS Like, supplemental, and other required regulatory reporting as well as PHP Board approved health management initiatives across the enterprise
The role assists with ensuring clinical and fiscal improvements and documents service delivery in accordance with Presbyterian Health Plan policies
The Senior Abstractor will be asked to perform duties where clinical decision-making may be necessary, training and over read responsibilities
Uses Performance Improvement tools and techniques to develop work plans, tasks, timelines, and measurements for all health management project assignments
Project plans will be developed for all projects and milestones monitored and reported
Identifies needs, designs valid and reliable tools for data collection, analyzes data, researches data and claims, and provides feedback in an appropriate format
May assist with development and implementation of quality initiatives
Monitors outcomes and quality of services provided
Performs Medical Record Reviews necessary to support quality initiatives and regulatory reporting, including but not limited to HEDIS reporting, CMS Star measures, FEHB measures, Medicaid, and supplemental data reporting
May be held to productivity standards as well as minimum over read standards
Manage an assigned caseload of provider locations and provide verbal and written progress regarding status of each providers submission of requested medical records
Excellent communication and facilitation skills are keys to success
Identify, analyze, and collect clinical information as it applies to HEDIS and NCQA requirements
Identify probable findings indicated by clinical documentation in the medical record
Documents abstracted findings into a HEDIS database tool
Track and report on issues and outcomes related to abstractions and over-reads
Integrate data collected from a variety of electronic and paper sources
Qualification
Required
High School Diploma Required
LVN, LPN, Coding Certification or other healthcare related field
Knowledge of medical terminology, knowledge of standard medical practices, medical assistant, medical coding or data management experience
Knowledge of Microsoft Applications, including Excel
At least one year of prior HEDIS Chart Abstraction experience
Preferred
Bachelor Degree
Registered Nurse (RN) with minimum 2 years clinical experience
Benefits
Medical
Dental
Vision
Short-term and long-term disability
Group term life insurance
Other optional voluntary benefits
Company
Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities they serve.
10001+ employees
H1B Sponsorship
Presbyterian Healthcare Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (86)
2023 (85)
2022 (93)
2021 (86)
2020 (76)
Funding
Current Stage
Late StageLeadership Team
Dale Maxwell
President and CEO
Ernest Sanchez
Chief Technology Officer
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