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 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
- Perform all other related duties as assigned.
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, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The hourly range for this role 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
