Remote Clinical Quality LPN, MN

Optum

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Requisition Number: 2193863
Job Category: Nursing
Primary Location: Eden Prairie, MN
(Remote considered)

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

 

The Clinical Quality LPN is responsible for direct provider outreach for year-round chart collection and abstraction. They assist with the coordination of HEDIS® and STARs data gathering and abstraction into Cozeva, DataRAP, and other applications as needed. This role partners with other Clinical Quality LPNs and the Supervisor of Quality Operations to ensure that medical record data is successfully retrieved and accurately abstracted.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

  

Primary Responsibilities: 

  • Outreach to provider offices to request medical record data
  • Act as a SME for data collection and HEDIS® questions, asked by provider offices
  • Review and abstract medical record data into appropriate application(s)
  • Follow up to offices that have failed to comply with a records request, or have sent incomplete chart documentation
  • Analyze chart data, evaluate for possible data integrity and/or data deficits and document findings
  • Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS®/Star measures
  • Support hybrid chart chase processes by requesting records from provider offices as needed
  • Maintain education/knowledgebase of HEDIS®/STARs standards and guidelines

  

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
  • 2+ years of experience with data analysis/quality chart reviews. Must be able to review medical records and assess completeness
  • 1+ years provider outreach
  • 1+ years HEDIS®/STAR experience
  • Experience using Microsoft office applications, including databases, word-processing, and Excel® spreadsheets
  • Proven excellent communication practices, both oral and written

 

Preferred Qualifications:

  • Associate degree
  • Undergraduate degree or equivalent experience
  • Certified Professional Coder
  • 1+ years call center experience

  

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $18.80 to $36.78 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.