LVN Case Manager - Quality Programs (HEDIS)
Job
Actalent
Victorville, CA (In Person)
$58,999 Salary, Full-Time
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Job Description
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LVN Case Manager - Quality Programs Job Description This role focuses on supporting HEDIS and quality gap closure activities, rather than traditional episodic case management. The LVN Case Manager is responsible for ensuring the accuracy, completeness, and compliance of medical record abstraction and data validation processes, impacting HEDIS measure performance, regulatory audits, and quality improvement efforts. Responsibilities Review and work on 20-30 medical records or member cases per day, adjusting for complexity. Ensure accuracy, completeness, and compliance in medical record abstraction. Review medical records across various provider EMR systems and paper chart repositories. Document findings accurately and ensure adherence to technical specifications. Contribute to departmental workflows and support annual training. Advance broader quality initiatives to achieve maximum CMS Star Ratings. Assist with other clerical duties as needed. Essential Skills Strong organizational and communication skills. Experience with HEDIS/STAR and medical records review. Proficiency in computer applications such as Excel, Word, Outlook, and PowerPoint. Additional Skills & Qualifications High School graduate. Graduate from an accredited school for Vocational Nurses. Current California LVN license. One year of LVN experience. Work Environment This role operates in a fully onsite office environment with a schedule from 8am to 5pm, Monday through Friday. The position requires wearing scrubs and is a minimum 12-week assignment to cover an LOA in the department. Job Type & Location This is a Contract position based out of Victorville, CA. Pay and Benefits The pay range for this position is $27.66 - $29.07/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Victorville,CA.
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