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