Licensed Vocational Nurse LVN/LPN Quality HEDIS/STARs San Antonio Texas
San Antonio, Texas
Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.
This position is responsible for the coordination of HEDIS and STARs data gathering process within the clinic setting. This role is responsible for the education to the clinic on quality measures and coordinates strategies for closing gaps. Evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, maintaining accurate records of review activities, developing formal training and improvement programs and maintaining up-to-date knowledge of regulatory (HEDIS/STARs) standards and guidelines.
Primary Responsibilities:
Required Qualifications:
Preferred Qualifications:
Physical & Mental Requirements:
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
This position is responsible for the coordination of HEDIS and STARs data gathering process within the clinic setting. This role is responsible for the education to the clinic on quality measures and coordinates strategies for closing gaps. Evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, maintaining accurate records of review activities, developing formal training and improvement programs and maintaining up-to-date knowledge of regulatory (HEDIS/STARs) standards and guidelines.
Primary Responsibilities:
- Analyze data, evaluate for possible data integrity and data deficits and document findings
- Analyze and trend HEDIS/STAR rates, identify barriers to improvement of rates and create interpretive exhibits
- Obtains quality detail report and flags patient's charts with the missing measures
- Works closely with local leadership to execute quality strategies
- Supports and assists PCPs/clinics with quality data collection
- Provides reports and monitors performance at local level
- Engages PCP and clinic staff in developing strategies to close quality gaps
- Supports and improves communications between market and corporate departments
- Maintains education/knowledge base of HEDIS/STARs standards and guidelines
- Performs all other related duties as assigned
Required Qualifications:
- Licensed Vocational/Professional Nurse
- Prior HEDIS/STAR experience or participation with similar regulatory reporting
- 3+ years of healthcare experience to include experience in a managed care setting
- 3+ years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement
- Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets
- This is an office / field base Position
Preferred Qualifications:
- 2+ years of college, in pursuance of a Bachelor's or Associate's degree
- 2+ years of experience working with HEDIS/STAR measures
Physical & Mental Requirements:
- Ability to lift up to 25 pounds
- Ability to sit for extended periods of time
- Ability to stand for extended periods of time
- Ability to use fine motor skills to operate office equipment and/or machinery
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Created: 2024-09-13
Reference: 2237708
Country: United States
State: Texas
City: San Antonio
ZIP: 78112
About UnitedHealth Group
Founded in: 1977
Number of Employees: 300000
Website: https://www.unitedhealthgroup.com/
Career site: https://careers.unitedhealthgroup.com/
Similar jobs:
-
University of Texas San Antonio - Fall 2024
HDR in San Antonio, Texas -
Financial Planning Director - Greater Texas (San Antonio, Austin)
Morgan Stanley in San Antonio, Texas -
Stocker-Texas - San Antonio-TX
Southern Glazer's Wine & Spirits in San Antonio, Texas💸 $16 - $18 per hour -
LVN/LPN Primary Source Verification Specialist San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
Coverage Senior Pharmacy Technician - Central Texas region including Austin, Texas and San Antonio, Texas
Comprehensive Cancer Centers of Nevada in Austin, Texas -
Supervisor Medical Claims Review San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
LVN/LPN Quality HEDIS/STARs Coordinator San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
RETAIL DISTRICT MANAGER UNASSIGNED-San Antonio, Texas
Dollar General in San Antonio, Texas -
Student Marketeer - University of Texas at San Antonio
Red Bull in San Antonio, Texas -
Registered Nurse Case Manager SNF Healthcare WellMed San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
Registered Nurse RN Utilization Management Quality Auditor San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
RN Clinical Coding Nurse Consultant WellMed San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
Registered Nurse RN Utilization Management Quality Auditor San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
Licensed Vocational Nurse LVN/LPN Mobile Clinic Healthcare San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
Associate Eligibility Specialist - Hybrid in San Antonio, Texas
UnitedHealth Group in San Antonio, Texas -
Licensed Vocational Nurse LVN/LPN Quality HEDIS/STARs Coordinator San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
RN Clinical Coding Nurse Consultant WellMed San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
RN Clinical Coding Nurse Consultant WellMed San Antonio Texas
UnitedHealth Group in San Antonio, Texas -
Maintenance Porter - San Antonio, Texas
LAZ Parking in San Antonio, Texas💸 $19 per hour -
Apple Support College Program At Home Advisor - University of Texas San Antonio
Apple in San Antonio, Texas