At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Clinical Quality LPN
Location
United States
Posted
15 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
The Clinical Quality LPN is responsible for Primary Source Verification and Supplemental Data Entry. They assist with the coordination of HEDIS® and STARs data gathering within various applications.
- Evaluate the quality and completeness of clinical documentation
- Perform quality medical record reviews
- Assist in the improvement of the clinical documentation process
- Maintain accurate records of review activities
- Ensure all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records
- Support end of year final push activities and hybrid chart chase processes
You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Schedule: Monday - Friday, 8:00 a.m. - 5:00 p.m. in your time zone
- Review and abstract medical record data into appropriate application(s)
- Support chart chase processes by requesting/obtaining records as needed
- Primary source verify abstracted medical record data
- Analyze chart data, evaluate for possible data integrity and/or data deficits and document findings
- Provide education and feedback to abstractors
- Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures
- Support member outreach campaigns within the H&C organization, as needed
- Maintain education/knowledgebase of HEDIS®/STARs standards and guidelines
- Assist team with re-training
- Perform all other related duties as assigned
Qualifications
- Licensed Professional/Vocational Nurse
- 3+ years of experience with data analysis/quality chart reviews
- 2+ years of HEDIS/STAR experience or participation with similar regulatory reporting
- Proven excellent communication practices, both oral and written
- Experience using Microsoft office applications, including databases, word-processing, and Excel spreadsheets
Requirements
- Associate degree (preferred)
- Undergraduate degree or equivalent experience (preferred)
- Certified Professional Coder (preferred)
- Training experience (preferred)
- Ability to be flexible in a continuously changing environment
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
Job Requirements
- Licensed Professional/Vocational Nurse
- 3+ years of experience with data analysis/quality chart reviews
- 2+ years of HEDIS/STAR experience or participation with similar regulatory reporting
- Proven excellent communication practices, both oral and written
- Experience using Microsoft office applications, including databases, word-processing, and Excel spreadsheets
- Associate degree (preferred)
- Undergraduate degree or equivalent experience (preferred)
- Certified Professional Coder (preferred)
- Training experience (preferred)
- Ability to be flexible in a continuously changing environment
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
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