Remote Clinical Quality LPN/LVN, MN

Optum

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Requisition Number: 2205686
Job Category: Nursing
Primary Location: Eden Prairie, MN
(Remote considered)

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and 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 Eastern time zone or Central time zone, 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:

  • High School Diploma / GED (or higher)
  • 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
  • Intermediate level of proficiency with Microsoft office applications, including databases, word-processing, and Excel® spreadsheets

Preferred Qualifications: 

  • Associate’s Degree
  • Certified Professional Coder
  • Training experience
  • Ability to be flexible in a continuously changing environment
  • Excellent communication practices, both oral and written

Physical & Mental Requirements:

  • Ability to sit for extended periods of time
  • Ability to use fine motor skills to operate office equipment
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Connecticut, New York, New Jersey, or Rhode Island Residents Only:  The hourly range for Connecticut, New York, New Jersey, or Rhode Island residents is $19.47 to $38.08 per hour. 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.

 

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.