HEDIS Quality LPN

1 month ago


San Antonio, United States Robert Half Full time
Job DescriptionJob Description

We are seeking a HEDIS Quality LPN to join our team based in San Antonio, Texas. The HEDIS Quality LPN focuses on HEDIS operations and data collection. The HEDIS Quality LPN position offers a short-term contract employment opportunity.


Responsibilities:

• Assist in medical records review to identify Star/HEDIS opportunities for the medical staff.

• Perform data collection and data entry tasks to close gaps in care.

• Collaborate with the leadership and clinical staff to identify trends and potential strategies to support the practice.

• Communicate any challenges or trends that may negatively impact quality outcomes.

• Track and trend barriers or challenges at assigned groups for better outcomes, including appointment access, follow-up on referrals, or inconsistent coding practices.

• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures.

• Support quality initiatives by requesting medical records from providers' offices as needed.

• Respond to incoming Clinical Quality inquiries from all communication avenues such as phone, fax queue, TruCare, or department email box.

• Conduct in-bound and out-bound calls for quality requirements including medical records requests and contact verification.

• Provide clerical and/or administrative support to quality staff and managers for special projects and reporting needs.

• Deliver excellent customer service by serving as a resource to all internal and external customers.

• Maintain education and knowledge base of HEDIS/STARs.

• Perform datamining tasks.

·      Licensed Practical Nurse

·      Minimum 2 year HEDIS experience and/or knowledge

·      Solid knowledge of managed care requirements related to clinical quality


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