Clinical Quality LPN - Telecommute
Company: UnitedHealth Group
Location: San Diego
Posted on: June 25, 2022
Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that is
improving the lives of millions. Here, innovation is not about
another gadget; it is about making health care data available
wherever and whenever people need it, safely and reliably. There is
no room for error. If you are looking for a better place to use
your passion and your desire to drive change, this is the place to
be. It's an opportunity to do -your life's best work.(sm) 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 Cozeva, DataRAP and other
applications as needed. This role evaluates the quality and
completeness of clinical documentation, by performing quality
medical record reviews, assisting in the improvement of the
clinical documentation process, maintaining accurate records of
review activities, ensuring all data submitted to the health plan
meets the HEDIS -/Star technical specifications for medical
records. If you are located in Mountain timezone and Central
timezone, you will have the flexibility to telecommute* as you take
on some tough challenges. - Primary Responsibilities:
- Review and abstract medical record data into appropriate
application(s)
- 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 chart chase processes by requesting records from
provider offices as needed
- Maintain education/knowledgebase of HEDIS -/STARs standards and
guidelines
- Assist team with re-training
- Perform all other related duties as assigned You'll be rewarded
and recognized for your performance in an environment that will
challenge you and give you clear direction on what it takes to
succeed in your role as well as provide development for other roles
you may be interested in. Required Qualifications:
- Licensed Professional/Vocational Nurse
- 3+ years of experience with data analysis/quality chart
reviews. Must be able to review data and provide recommendations
for improvement
- 2+ years of HEDIS -/STAR experience or participation with
similar regulatory reporting
- Experience using Microsoft office applications, including
databases, word-processing, and Excel - spreadsheets Preferred
Qualifcations:
- Associate degree
- Undergraduate degree or equivalent experience
- Certified Professional Coder
- Training experience
- Ability to be flexible in a continuously changing
environment
- Excellent communication practices, both oral and written
- Full COVID-19 vaccination is an essential job function of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all federal, state and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to employment to
ensure compliance. Candidates must be able to perform all essential
job functions with or without reasonable accommodation Physical &
Mental Requirements:
- Ability to lift up to 25 pounds
- Ability to sit 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 To protect the health and safety of our workforce, patients
and communities we serve, UnitedHealth Group and its affiliate
companies require all employees to disclose COVID-19 vaccination
status prior to beginning employment. In addition, some roles and
locations require full COVID-19 vaccination, including boosters, as
an essential job function. UnitedHealth Group adheres to all
federal, state and local COVID-19 vaccination regulations as well
as all client COVID-19 vaccination requirements and will obtain the
necessary information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employment Careers with Optum.
-Here's the idea. We built an entire organization around one giant
objective; make health care work better for everyone. So when it
comes to how we use the world's large accumulation of
health-related information, or guide health and lifestyle choices
or manage pharmacy benefits for millions, our first goal is to leap
beyond the status quo and uncover new ways to serve. Optum, part of
the UnitedHealth Group family of businesses, brings together some
of the greatest minds and most advanced ideas on where health care
has to go in order to reach its fullest potential. For you, that
means working on high performance teams against sophisticated
challenges that matter. Optum, incredible ideas in one incredible
company and a singular opportunity to do -your life's best
work.(sm) Colorado Residents Only: -The hourly range for Colorado
residents is $18.17 to $32.26. Pay is based on several factors
including but not limited to education, work experience,
certifications, etc. In addition to your salary, UnitedHealth Group
offers benefits such as, a comprehensive benefits package,
incentive and recognition programs, equity stock purchase and 401k
contribution (all benefits are subject to eligibility
requirements). No matter where or when you begin a career with
UnitedHealth Group, you'll find a far-reaching choice of benefits
and incentives. *All Telecommuters will be required to adhere to
UnitedHealth Group's Telecommuter Policy. 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.
Keywords: UnitedHealth Group, San Diego , Clinical Quality LPN - Telecommute, Healthcare , San Diego, California
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