HEDIS Quality LPN
1 month ago
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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