There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) This position is responsible for the coordination of HEDIS and STARs data gathering process within the clinic setting. This role is responsible for the education to the clinic on quality measures and coordinates strategies for closing gaps. Evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, maintaining accurate records of review activities, developing formal training and improvement programs and maintaining up-to-date knowledge of regulatory (HEDIS / STARs) standards and guidelines.Primary Responsibilities:Analyze data, evaluate for possible data integrity and data deficits and document findings Analyze and trend HEDIS / STAR rates, identify barriers to improvement of rates and create interpretive exhibits Obtains quality detail report and flags patient's charts with the missing measures Works closely with local leadership to execute quality strategies 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 close quality gaps Supports and improves communications between market and corporate departments Maintains education/knowledge base of HEDIS / STARs standards and guidelines Performs all other related duties as assigned
Required Qualifications:Licensed Vocational / Professional Nurse Prior HEDIS / STAR experience or participation with similar regulatory reporting 3 or more years of healthcare experience to include experience in a managed care setting 3 or more years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of diseasePreferred Qualifications:2 or more years of college, in pursuance of a Bachelor's or Associate's 2 or more years of experience working with HEDIS / STAR measuresCareers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: LVN, Quality coordinator, Dallas, Texas, TX
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.