HEDIS Medical Records Abstractor

US-CA-San Francisco
Job ID
Health Services
Temporary Full-Time


Established in 1997, San Francisco Health Plan (SFHP) is a an award winning,  managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. San Francisco Health Plan is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 145,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.




The San Francisco Health Plan (SFHP) is seeking three energetic and technologically-savvy Medical Record Abstractors for our HEDIS pursuit project. Medical Record Abstractors may have one of the following degrees to apply: Registered Nurse (RN), Licensed Vocational Nurse (LVN), Registered Health Information Technician (RHIT), or Medical Assistant (MA). Abstractors will help measure the quality of preventive and chronic care services SFHP members receive.  The primary responsibilities of these positions are 1) conducting medical record reviews to identify whether SFHP members received necessary services per national clinical guidelines, and 2) entering data into a database. Some of the services include diabetes tests, immunizations, and annual visits. 


The abstractors will work in the field (clinics, provider offices and hospitals with which SFHP is contracted) part of the time and in the office part of the time. HEDIS (Healthcare Effectiveness Data and Information Set) training will be provided. The candidate should be able to work 40 hours per week during the HEDIS season from January 16, 2018 to May 8, 2018.


This is a temporary position. 



  • Reviews assigned medical records in order to abstract clinical data elements for HEDIS reporting, e.g. results of laboratory tests, verification of hypertension and the most recent blood pressure reading, prenatal and postpartum care services, etc.
  • Documents abstraction findings into HEDIS database tool
  • Communicates additional pursuit strategies for additional medical records, if needed, to other members of the team
  • Integrates data collected from a variety of electronic and paper sources
  • Communicates significant findings, including potential risk management issues, to the Clinical Quality Department in a timely manner



  • Candidates must be proficient with databases and with conducting 100% of work activities on the computer
  • Medical background (RN, RHIT, LVN or MA)
  • Excellent interpersonal skills and ability to work effectively in team environment
  • Demonstrated command of medical terminology, medical record documentation, and clinical processes
  • Ability to produce accurate and precise work
  • Strong time management skills
  • Experience with an Electronic Health Record (EHR) system strongly recommended
  • Knowledge of ICD-9-CM, CPT, and HCPCS coding conventions a plus


NOTE:  This description is not intended to be construed as an exhaustive list of duties, responsibilities or requirements for the position.  This position may change or assume additional duties at any time.  The employee may be requested to perform different or additional duties as assigned.

San Francisco Health Plan is an Equal Opportunity Employer (EOE) M/F/D/V

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records


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