LVN/LPN Quality HEDIS/STARs Coordinator San Antonio Texas Position Available In Washington, Alabama

Job Description:

• $1K Sign on Bonus for External Candidates
• WellMed, part of the Optum family of businesses, is seeking aLVN/LPN Quality HEDIS/STARs Coordinator to join our team in SanAntonio, Texas. Optum is a clinician-led care organization that ischanging the way clinicians work and live.
• As a member of the Optum Care Delivery team, you’ll be an integralpart of our vision to make healthcare better for everyone.
• At Optum, you’ll have the clinical resources, data and support of aglobal organization behind you so you can help your patients livehealthier lives.

Here, you’ll work alongside talented peers in acollaborative environment that is guided by diversity and inclusionwhile driving towards the Quadruple Aim. We believe you deserve anexceptional career, and will empower you to live your best life atwork and at home. Experience the fulfillment of advancing thehealth of your community with the excitement of contributing newpractice ideas and initiatives that could help improve care formillions of patients across the country. Because together, we havethe power to make health care better for everyone. Join us anddiscover how rewarding medicine can be while

• Caring.

Connecting.

Growing together.

• This position is responsible for the coordination of HEDIS andSTARs data. This role is responsible for education to the patienton quality measures and coordinates strategies for closing gaps
• The Quality Coordinator LVN, through telephonic outreaches willeducate patients on

CAHPS & HOS

components while working to closeother HEDIS gaps for patients. Evaluates the quality andcompleteness of clinical gap closures by performing quality reviewswith patients, maintaining clinical documentation, and accuratelyrecords of their review activities. The Quality Coordinator LVNwill maintain up-to-date knowledge of regulatory (HEDIS/STARs)standards and guidelines.•

Position Highlights & Primary Responsibilities:

Analyze data, evaluate for possible data integrity and datadeficits and document findings Analyze and trend

HEDIS/STAR

rates, identify barriers toimprovement of rates and create interpretive exhibits Identifies patients with the missing measures and works to closethe measures through education/counseling, appointment setting, andother means as appropriate Conduct a high volume of outbound calls to members to discussreasons for non-compliant to medication(s), schedule pharmacytelephonic appointments, and/or obtain important follow upinformation from providers. Outbound calls are made primarily usingan auto dialer requiring precision to detail and adaptability to type of response needed May answer inbound calls from members and assists them with theirinquiries. Routes calls to appropriate department if necessary Follows system scripting and validates member demographicinformation Documents the provider or member’s record with accurate informationobtained on the call Works closely with local leadership to execute qualitystrategies Supports and assists PCPs/clinics with quality data collection Provides reports and monitors performance at local level Engages PCP and clinic staff in developing strategies to closequality gaps Maintains education/knowledge base of HEDIS/STARs standards andguidelines Performs all other related duties as assigned

• -This is an office-based position located near Interstate HighwayI-10 West, near West Frontage Road just past The Rim ShoppingCenter/Ferrari Dealership, 78257
• In 2011, WellMed partnered with Optum to provide care to patientsacross Texas and Florida.

WellMed is a network of doctors,specialists and other medical professionals that specialize inproviding care for more than 1 million older adults with over16,000 doctors’ offices. At WellMed our focus is simple. We’reinnovators in preventative health care, striving to change the faceof health care for seniors. WellMed has more than 22,000+ primarycare physicians, hospitalists, specialists, and advanced practiceclinicians who excel in caring for 900,000+ older adults. Together,we’re making health care work better for everyone.

• -You’ll be rewarded and recognized for your performance in anenvironment that will challenge you and give you clear direction onwhat it takes to succeed in your role as well as providedevelopment for other roles you may be interested in.

RequiredQualifications:

Licensed Vocational/Professional Nurse 3+ years of healthcare experience to include experience in amanaged care setting 3+ years of experience with data analysis/quality chart reviews.

Must be able to review data and provide recommendations forimprovement

HEDIS/STAR

experience or participation with similar regulatoryreporting Experienced using Microsoft office applications, includingdatabases, word-processing, and excel spreadsheets•

Preferred Qualifications:

2+ years of college, in pursuance of a Bachelor’s or Associate’sdegree 2+ years of experience working with

HEDIS/STAR

measures

• The hourly range for this role is $19.

86 to $38.85 per hour basedon full-time employment. Pay is based on several factors includingbut not limited to local labor markets, education, work experience,certifications, etc. UnitedHealth Group complies with all minimumwage laws as applicable. In addition to your salary, UnitedHealthGroup offers benefits such as, a comprehensive benefits package,incentive and recognition programs, equity stock purchase and 401kcontribution (all benefits are subject to eligibilityrequirements). No matter where or when you begin a career withUnitedHealth Group, you’ll find a far-reaching choice of benefitsand incentives.

• OptumCare
• is an Equal Employment Opportunity employer underapplicable law and qualified applicants will receive considerationfor employment without regard to race, national origin, religion,age, color, sex, sexual orientation, gender identity, disability,or protected veteran status, or any other characteristic protectedby local, state, or federal laws, rules, or regulations.
• OptumCare is a drug-free workplace.

Candidates are required to passa drug test before beginning employment.