LVN/LPN Quality HEDIS/STARs Coordinator San Antonio Texas
3 weeks ago
Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.
This position is responsible for the coordination of HEDIS and STARs data. This role is responsible for education to the patient on quality measures and coordinates strategies for closing gaps. The Quality Coordinator LVN, through telephonic outreaches will educate patients on CAHPS & HOS components while working to close other HEDIS gaps for patients. Evaluates the quality and completeness of clinical gap closures by performing quality reviews with patients, maintaining clinical documentation, and accurately records of their review activities. The Quality Coordinator LVN will maintain up-to-date knowledge of regulatory (HEDIS/STARs) standards and guidelines.
This is an office-based position located near Interstate Highway I-10 West, near West Frontage Road just past The Rim Shopping Center/Ferrari Dealership, 78257
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
* Identifies patients with the missing measures and works to close the measures through education/counseling, appointment setting, and other means as appropriate
* Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Outbound calls are made primarily using an auto dialer requiring precision to
* detail and adaptability to type of response needed
* May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary
* Follows system scripting and validates member demographic information
* Documents the provider or member's record with accurate information obtained on the call
* 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
* Maintains education/knowledge base of HEDIS/STARs standards and guidelines
* Performs 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 Vocational/Professional Nurse
* 3+ years of healthcare experience to include experience in a managed care setting
* 3+ years of experience with data analysis/quality chart reviews. Ability to review data and provide recommendations for improvement
* HEDIS/STAR experience or participation with similar regulatory reporting
* Experience using Microsoft office applications, including databases, word-processing, and excel spreadsheets
Preferred Qualifications:
* 2+ years of college, in pursuance of a Bachelor's or Associate's degree
* 2+ years of experience working with HEDIS/STAR measures
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: 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.
-
Gonzales, United States Optum Full timeOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you...
-
Stars Coordinator
2 days ago
Gonzales, United States Optum Full timeOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you...
-
Gonzales, United States UnitedHealth Group Full time**WellMed, part of the Optum family of businesses, is seeking a RN Clinical Coding Nurse Consultant WellMed to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live.** **As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for...
-
Gonzales, Texas, United States Soliant Full timeJob OverviewWe are seeking an experienced Occupational Therapist to join our team at Soliant in a dynamic school-based setting. This is a full-time contract position for the 2024-2025 school year, offering a competitive salary and comprehensive benefits package.Job SummaryThe successful candidate will work with students in a school-based setting near San...
-
LPN Pediatric Private Duty
4 weeks ago
Gonzales, United States LHC Group Full timeSummary We are hiring a Pediatric Private Duty LPN (Licensed Practical Nurse) in the Gonzales area to provide pediatric private duty care. Case Specific Enhanced Pay Rates are available with 8-12 shifts We offer FT/PT hours, flexible schedules, and weekly pay We strive to offer benefits that reward the whole you! * employee wellness programs *...
-
Full-Time Occupational Therapist
4 months ago
Gonzales, United States Soliant Full timeJob DescriptionJob DescriptionMinimum 1+ years occupational therapy experience required.Full Time Occupational Therapist (OT) TexasSoliant is seeking a licensed Occupational Therapist for a school-based job near San Antonio, Texas. This is a Full-Timecontract job for the 2024-2025school year. Applicants with previous school-based experience are preferred....
-
Social Services Coordinator
3 weeks ago
Gonzales, Texas, United States Volunteers of America-Texas Full timeVolunteers of America-Texas is seeking a Social Services Coordinator to join our team in Gonzales, TX. This part-time opportunity offers a competitive salary of $19.00 per hour.About the Role:Develop and implement individualized case plans for residents.Establish relationships with community agencies and service providers to ensure access to essential...
-
Home Care RN/LPN Position
2 weeks ago
Gonzales, Louisiana, United States Aveanna Full timeHome Health Nursing OpportunityAveanna Healthcare is seeking a dedicated and caring LPN to provide high-quality care to patients in their homes. As a Private Duty Nurse, you will be responsible for assessing patient needs, implementing care plans, and providing ongoing support to families. This is a rewarding opportunity to make a positive impact on...
-
Service Coordinator I
3 weeks ago
Gonzales, United States Volunteers of America-Texas Full timeVOA - Texas Are you looking for a job that makes a difference? Do you have a passion for helping others? We may be the right organization for you: VOA - Texas. Location: Country Village - Gonzales, TX Pay: $19.00 Status: Part Time Why you'll love working with VOA-Texas: Reliable hours: We will provide a dependable schedule you can count on. Career...
-
Service Coordinator I Assistant
1 week ago
Gonzales, Texas, United States Volunteers of America-Texas Full timeMake a difference in the lives of others with Volunteers of America-Texas. We are seeking a Service Coordinator I to join our team in Gonzales, TX. This is a part-time opportunity with a competitive salary of $19.00 per hour.The successful candidate will be responsible for providing informal assessments and developing tailored case plans for residents. They...
-
Aveanna Healthcare Private Duty Nurse LPN
2 months ago
Gonzales, United States Aveanna Healthcare Full timeRequisition #:191764 Location:Gonzales, LA 70737 Category:Nursing Salary:Up to $26.00 per hour Position Details Aveanna Private Duty Nurse - LVN/LPN RN Aveanna's Private Duty nurses assist our patients with transitioning home from the hospital and provide the continuous care needed to remain at home with their loved ones. We match our nurses to their...
-
Clinical Care Coordinator
1 month ago
Gonzales, Louisiana, United States Our Lady of the Lake Regional Medical Center Full timeJob SummaryWe are seeking a skilled Licensed Practical Nurse to join our team at Our Lady of the Lake Regional Medical Center. As an LPN, you will play a vital role in providing high-quality patient care and ensuring seamless coordination of services.About the RoleThis position offers a competitive salary range of $65,000 - $85,000 per year, depending on...
-
Gonzales, Texas, United States CHG Healthcare Full timeThis is an exciting opportunity to join a nice group of healthcare professionals in Gonzales, a historic town in central Texas. This employed position offers a competitive salary and negotiable sign-on bonus, relocation assistance, and loan repayment.The practice is equipped with robotics and has a high volume of deliveries, with 151 total number of...
-
RN Weekend Supervisor
2 months ago
Gonzales, United States Nexion Health Full timeRegistered Nurse Weekend Supervisor needed, very flexible hours! 8 hours Saturday and Sunday...open to every weekend or every other weekend Starting rate: $34 - $39 / hr. based on experience for Sat-Sun RN Weekend Supervisor INDNUR Ask us about or Level 1 and 2 educational programs. RN/LVN/LPNs can earn up to an additional $1.50 per hour. We also offer...
-
Gonzales, United States UnitedHealth Group Full time**WellMed, part of the Optum family of businesses, is seeking a Registered Nurse Case or Utilization Manager to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live.** **As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for...
-
Licensed Practical Nurse
4 weeks ago
Gonzales, United States Our Lady of the Lake Regional Medical Center Full time$2000 sign on bonus for a qualified LPN to join our Podiatry Clinic in Ascension. LPN Clinic is responsible for providing patient care following established standards and practices. Assists physician, nurse, and staff with the daily coordination of patient care and patient access. Coordinates patient flow, schedules appointments, procedures, tests and...
-
Licensed Practical Nurse
7 hours ago
Gonzales, United States Our Lady of the Lake Regional Medical Center Full time$2000 sign on bonus for a qualified LPN to join our urology clinic. LPN Clinic is responsible for providing patient care following established standards and practices. Assists physician, nurse, and staff with the daily coordination of patient care and patient access. Coordinates patient flow, schedules appointments, procedures, tests and referrals. May serve...
-
Gonzales, Texas, United States Soliant Full timeSeeking a skilled Speech Language Pathologist to join our team in DeSoto, TX. This is a full-time position serving students from Pre-K through 12th grade with varying levels of speech and language needs.Job OverviewWe are a dynamic and supportive educational institution committed to providing high-quality services to our students. Our ideal candidate will...
-
Licensed Practical Nurse
4 months ago
Gonzales, United States Our Lady of the Lake Regional Medical Center Full timeLPN Clinic is responsible for providing patient care following established standards and practices. Assists physician, nurse, and staff with the daily coordination of patient care and patient access. Coordinates patient flow, schedules appointments, procedures, tests and referrals. May serve as a preceptor for clinical staff. Relies on guidelines to...
-
Licensed Practical Nurse
4 months ago
Gonzales, United States Our Lady of the Lake Regional Medical Center Full timeLPN Clinic is responsible for providing patient care following established standards and practices. Assists physician, nurse, and staff with the daily coordination of patient care and patient access. Coordinates patient flow, schedules appointments, procedures, tests and referrals. May serve as a preceptor for clinical staff. Relies on guidelines to...
