Quality Improvement Abstractor

Quality Improvement Abstractor at Presbyterian Healthcare Services

9521 San Mateo NE, Albuquerque, New Mexico , United States of America

Minimum

Offer:

$48,068.80

Maximum

Offer:

$73,403.20

Full-time. Exempt. Job is based at Reverend Hugh Cooper Administrative Center. Days shift (United States of America).

Build your Career. Make a Difference. Presbyterian is hiring a skilled Quality Improvement Abstractor to join our team.

• 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, Centennial Care, 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 provider's 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. Communicate significant findings, including potential risk management issues to the Manager in a timely manner.

• High School Diploma or equivalent
• 2-3 years healthcare experience
• Experience working within Electronic Health Records
• Experience with medical terminology, knowledge of standard medical practices, medical assistant, medical coding or data management experience

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in your personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees—including more than 1,600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services