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HEDIS Abstractor

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Business Support
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0143385 Requisition #

Responsible for HEDIS medical record identification and abstraction. Primary duties may include, but are not limited to: Conducts medical record abstraction audits of medical records. Serves as a resource and subject matter expert on HEDIS quality reviewer processes. Conducts over-reads on HEDIS records for compliance against HEDIS Technical Specifications and ensures feedback is considered. Identifies patterns and interprets clinical handwriting of providers. Gathers and analyzes data, and organizes and writes reports. Educates providers on HEDIS specifications and medical record documentation via various mediums such as HEDIS Encounter Portal Submission Tool, Hybrid Review Tool, HEDIS reference material development, and any other educational pieces for Provider relations, etc. Provides feedback to providers via the HEDIS Encounter Submission Tool for medical records and ensures feedback is considered. Reviews HEDIS Encounter Portal submissions for Star Metrics within given set deadlines. Works on projects as assigned. Develops expertise in the requirements and parameters of mandated HEDIS performance measures on an annual basis. Requires a degree in nursing, healthcare administration, or related field; 2 years of clinical experience including medical record noting, auditing, and data abstraction, and HEDIS experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted clinical license appropriate to field of specialty (RN/LPN) required. Active state license required. 2 years of experience as a HEDIS medical chart reviewer preferred. Knowledge of population health (epidemiology) and quality improvement concepts and intervention. Knowledge of population health (epidemiology) and quality improvement concepts and intervention required. Experience with daily operations in a clinical, managed care, hospital care setting including working with provider systems and medical providers required.

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Be Part of an Inclusive Culture

Workforce Diversity

At Anthem Inc., we believe that having a diverse workforce is critical to innovation and to addressing the needs of the diverse customers and communities we serve. Women make up 76% of our workforce and 63% of all management roles. People of color represent 43% of our workforce and 29% of management. More about the breakout of our workforce in Anthem Corporate Responsibility.

Workforce Recruitment

Our commitment to improving access to affordable care while simplifying the health care experience for consumers requires the best talent, passion, broad insight and experience, and an innovative mindset.

We partner with external organizations, colleges and universities, and our nine associate resource groups to recruit, retain, and develop a workforce that reflects the communities we serve -- and to implement best practices to offer an inclusive environment for all. Our partnerships include: UNCF, United States Business Leadership Network (USBLN); National Association on Disability (NOD), Amerigroup National Advisory Board; Easter Seals; Job Accommodation Network (JAN); MindShift; VeteranRecruiting; HirePurpose; Hiring Our Heroes; Military Spouse Corporate Career Network; Out & Equal; Hispanic Association on Corporate Responsibility (HACR); Diversity Best Practices, among many others.

Associate Resource Groups

Our nine Associate Resource Groups (ARGs) include associates from all areas of the organization, multiple locations and a wide-range of experiences and backgrounds. The groups encourage diversity of perspectives and insight and help put the passion of our associates into action in order to make a real difference for our consumers and the communities we serve. Our ARGs help tackle business issues, participate in community programs, and facilitate opportunities for education, development, and networking. ARGs are open to all Anthem associates.

  • ABLE: Disability Inclusion Network
  • ACE Asians Committed to Excellence
  • APEX African American Professional Exchange
  • HYPE Healthcare Your Professional Exchange
  • PRIDE Promoting Respect, Individuality, Diversity and Equality
  • SOMOS Hispanic ARG
  • VOA Veterans of Anthem
  • W@VE Working @ Anthem in a Virtual Environment
  • WIN Women’s Inspired Network

LGBTQ inclusion – SAFE Space and Gender Transition Guidelines

We are proud to be recognized by the HRC among the Best Places to Work for LGBTQ Equality by obtaining a perfect score in the Corporate Equality Index. Our PRIDE ARG helps us identify and implement best practices and programs such as the Anthem Safe Space Program, the Gender Inclusion and Transition Guidelines, and Transgender Training for customer-facing associates. This ARG also helped create “Building an LGBT –Friendly Practice”, an online training module that we offer to all health care providers.

People with Disabilities

We have a strong commitment to the employment of people with disabilities and partner closely with external organizations and our ABLE ARG to nurture a culture and a physical environment that are both inclusive of associates as well as customers with disabilities. We have received the Leading Disability Employer Seal by NOD (2016-2017), a perfect score in the USBLN’s Disability Equality Index since 2016 and the Portlight “Getting It Right” Award in 2017 for our work in disaster preparedness and recovery for people with disabilities.

Veterans

It's important to us to offer our veterans opportunities to take their career in a new direction because we believe their spirit of service is essential to improving health care. Our VOA ARG partners with Talent Acquisition to maximize our ability to attract and retain veterans and their family members. The group also focuses on supporting our troops by sending care packages during the holidays and participating in events year-round. Learn more in our veterans’ page.

Unconscious Bias training

We train our leaders to make more informed and effective decisions by mitigating unconscious bias. There’s extensive research about the impact of unintended bias in decisions that affect people in the workplace so in 2017 we launched “Decide: The Neuroscience of Breaking Bias,” an eLearning experience that helps leaders identify, label and take action to minimize bias in order to build effective and inclusive teams.

Connect With Our Communities

Our associates are passionate about serving our members and giving back to the community and the company supports these efforts through several programs.

Year-round, Anthem associates give generously to health-related nonprofit organizations across the country through our Associate Giving Program, which offers a 50 percent match from the Anthem Foundation.

The Dollars for Doers program encourages year-round associate volunteerism—and helps associates’ commitment go even further by providing grants to eligible organizations where the volunteer service is completed. In 2017, our associates logged over 55,000 hours! To make it even easier to volunteer, associates can have up to eight hours of paid volunteer time off each year to be used to volunteer at qualified charities of their choice.

The Volunteer Recognition Program invites Anthem associates to share their volunteer stories or nominate their colleagues who volunteer in the community. Each quarter associates nominate and vote for a winner who exemplifies our value of Caring for Our Communities. The winner chooses an eligible charity to receive a special grant from the Anthem Foundation.

Learn more about how Anthem associates give back to their communities.

 
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