Remote Senior Clinical Quality RN – HEDIS, Las Vegas, NV

UnitedHealthcare

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Requisition Number: 2217851
Job Category: Nursing
Primary Location: Las Vegas, NV
(Remote considered)

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Senior Clinical Quality RN will be the primary person responsible for conducting medical record review to support required HEDIS and quality improvement activities. This person will work with the well trained HEDIS data collection team of nurses to oversee timely and accurate data collection and interrater reliability testing.

If you are located within a commutable distance from the Las Vegas, NV area, you will have the flexibility to work remotely* as you take on some tough challenges.

  

Primary Responsibilities:

  • Perform HEDIS medical record review for physician offices throughout the state of Nevada
  • Complete inter-rater reliability testing and required computer training successfully in order to complete this data collection
  • Conduct additional QI audits through medical record review
  • Educates physicians, RNs and other clinical employees in the latter half of the year

 

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: 

  • Current unrestricted RN license in the state of Nevada
  • Experience educating Physicians, RNs or other clinical and/or non-clinical employees
  • Electronic Medical Records (EMR) experience
  • HEDIS data collection and medical record / chart review experience
  • Proficient with MS Word, Excel and PowerPoint
  • Proven ability to perform chart collection and data abstraction in a provider office setting
  • Willing and able to travel 25% +/- depending on business need
  • Reside within commutable distance to Las Vegas, NV

 

Preferred Qualifications:

  • Active Certified Professional Coding (CPC) Certification
  • 2+ years Clinical Quality experience in acute care or managed care setting
  • Experience creating and maintaining training curriculums
  • Medical Record Audit experience a plus (medical record review and capturing / documenting appropriate clinical information needed to assure compliance)
  • Proven to be self-motivated and able to learn new computer software quickly
  • Proven ability to demonstrate knowledge and to apply to job functions, those state and federal laws and regulations applicable to the operation unit

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

Nevada Residents Only: The salary range for this role is $70,200 to $137,800 annually. 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.