LVN HEDIS Quality Consultant In Office in Austin Texas
Company: Optum
Location: Round Rock
Posted on: March 1, 2025
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Job Description:
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 Primary Source Verification
process and coordination of HEDIS and STARs data gathering process
within the eCW and DataRaps applications. -This role 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, ensures all data submitted
to the health plan meets the HEDIS/Star technical specifications
for medical records. -
Primary Responsibilities:
Analyze data, evaluate for possible data integrity and data
deficits and document findings
Over reads the data entry of non-standard supplemental data
obtained from medical record review
Navigate multiple documentation systems and obtain medical record
sections supportive of HEDIS/Star measures
Review of scanned records and data entry into DataRaps
application
Support chart chase process by requesting records from provider's
offices as needed
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
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 Vocational/Professional Nurse -
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
HEDIS/STAR experience or participation with similar regulatory
reporting
This position requires Tuberculosis screening as well as proof of
immunity to Measles, Mumps, Rubella, Varicella, Tetanus,
Diphtheria, and Pertussis through lab confirmation of immunity,
documented evidence of vaccination, or a doctor's diagnosis of
disease -
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 push or pull heavy objects using up to ___ pounds of
force -
Ability to properly drive and operate a company vehicle -
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.
Keywords: Optum, Round Rock , LVN HEDIS Quality Consultant In Office in Austin Texas, Administration, Clerical , Round Rock, Texas
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