Remote Clinical Quality LPN, MN

Optum

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Requisition Number: 2216567
Job Category: Nursing
Primary Location: Minnetonka, 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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.  

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
  • Maintain education/knowledgebase of HEDIS®/STARs standards and guidelines
  • Assist team with re-training
  • Perform all other related duties as assigned

What are the reasons to consider working for UnitedHealth Group?   Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

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 Practical Nurse in state of residence
  • 3+ years of experience with data analysis/quality chart reviews including the ability to review data and provide recommendations for improvement
  • 2+ years of HEDIS®/STAR experience
  • 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

Soft Skills:

  • 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.

California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii or Washington Residents Only:  The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island or Washington residents is $19.47 to $38.08 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.