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Licensed Vocational Nurse, LVN / LPN, Quality Improvement, HEDIS / STARS - San Antonio, TX

01/11/2019Call Center
Job Location:
San Antonio, TX
Metro Area:
TX - San Antonio
Company Name: UnitedHealth Group
Website:  Click to Visit
UnitedHealth Group
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)     The Clinical Quality LVN will assist in driving consistency, efficient processes and share best practices – in a collaborative effort with the Quality Improvement team and leadership– designed to facilitate a minimum 4 STAR rating. The LPN will participate in quality improvement HEDIS STAR initiatives, such as Care of Older Adults (COA) Functional Status and Pain Assessments, and other department initiatives; develop recommendations for quality remediation plans and create tools to capture relevant data for each region. This position will work collaboratively with other staff member, leadership and Market staff in a matrix relationship. Primary Responsibilities: Develop market business plans to motivate providers to engage in improving Stars measures to be 4 STARS or higher Outreach to members to provide patient education & assessments, required yearly assessments, and other quality campaign initiatives Perform data mining in all systems to help close gaps in care Be the primary go to person for all STARS related activities within their assigned market(s) working within a matrix relationship which includes other Quality staff, leadership, and Market staff Assist in developing of training and analytical materials for assigned Stars and HEDIS campaigns Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies Identify and assess decision makers and other key provider group personnel with a focus on identifying barriers to achieving targeted outcomes Focus communications and efforts accordingly Develop solution-based, user friendly initiatives to support practice success This is a call center position near Northwest Pkwy., 78249


Required Qualifications: Current License Vocational Nurse (LVN) 1+ year of HEDIS/Stars experience 3+ years associated business experience with health care industry Professional experience persuading changes in behavior Knowledge base of clinical standards of care, preventative health, and Star measures Experience in managed care working with network and provider relations Basic knowledge of Microsoft Office programs, including Word and Excel Ability to accurately document information and maintain patient confidentiality Preferred Qualifications: Call Center Experience Strong communication and presentation skills Strong relationship building skills with clinical and non-clinical personnel Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels Ability to solve process problems crossing multiple functional areas and business units Strong problem-solving skills; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of action Medical/clinical background Bilingual Physical and Mental Requirements: Ability to sit for extended periods of time Ability to stand for extended periods of time Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex problem solving Careers 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 240,000+ 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: Licensed Vocational Nurse, LVN, LPN, HEDIS, STARS, Quality Improvement, San Antonio, TX, Texas, Gonzales, Helotes, Shiner, Yoakum, New Braunfels, Seguin, Boerne, Floresville
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