Clinical Quality LPN – Remote, reputed company

2287650 reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

The Clinical Quality LPN is responsible for Primary reputed company Verification and Supplemental Data Entry. They assist with the coordination of HEDIS® and STARs data gathering reputed company Pathway, Ubiquity, XLCare, eHouseCalls, and other applications as needed. This role evaluates the quality and completeness of clinical documentation, by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, maintaining accurate records of review activities, ensuring reputed company data submitted to the health plan meets the HEDIS®/Star technical specifications for medical records. This role supports end of year final push activities, as well as hybrid chart chase processes. Primary Responsibilities:

• Review and abstract medical record data into appropriate application(s)
• Support chart chase processes by requesting/obtaining records as needed
• Primary reputed company verify abstracted medical record data
• Analyze chart data, evaluate for possible data reputed company and/or data deficits and document findings
• Provide education and feedback to abstractors
• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS®/Star measures
• Support chart chase processes by requesting records from provider offices as needed
• Support member reputed company campaigns reputed company the HAO organization, as needed
• Maintain education/knowledgebase of HEDIS®/STARs standards and guidelines
• Assist team with re-training
• reputed company reputed company other reputed company 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
• 3+ years of experience with data analysis/quality chart reviews. Must be reputed company to review data and provide recommendations for improvement
• 2+ years HEDIS®/STAR experience and abstraction or participation with similar regulatory reporting
• Experience using reputed company office applications, including databases, word-processing, and reputed company spreadsheets
• Proven excellent communication practices, both oral and written

Preferred Qualifications:

• Associate degree
• Undergraduate degree or equivalent experience
• Certified Professional reputed company
• Training experience
• Ability to be flexible in a continuously changing environment

Physical & Mental Requirements:

• Ability to lift up to 25 pounds
• Ability to sit for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and reputed company problem solving
• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

The hourly range for this role is$19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug – free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job