At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Clinical Quality LPN engages in a collaborative process with members of a multidisciplinary team which may include a Physician, Nurse Practitioner, RN Care Manager, Social Worker, Pharmacist, Clinical Quality Coordinator, and Medical Assistant, to improve HEDIS and STARs scores.

The Clinical Quality LPN performs a wide variety of duties and is responsible for driving clinical relationships and engagement with providers, patients, and pharmacies with a goal of improving health, well-being, and quality performance. This position is accountable for the full range of clinical practice performance which may include but is not limited to improvement on HEDIS and STARs gap closures.  This role develops a comprehensive, provider-specific plan to increase their physician practice performance and improve their outcomes.

If you are located in New Orleans, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Run/pull/prioritize/distribute Quality and Med Adherence reports for all Quality Contract Payors
• Analyzes data collected and makes recommendations for process improvements
• Assist in the development and implementation of new policies and procedures designed to enhance quality care
• Perform Chart reviews to identify open gap measures
• Communicate with Clinical Team on open gaps
• Available resource for Clinical questions from Clinical Quality Administrative Coordinator
• Perform Med Adherence Calls
• Maintain Quality reports for each provider
• Perform initial and follow-up calls to patients for open gap measures
• Review/interpret internal medical records/data to determine whether there is documentation that medical services were rendered to close Quality Gaps
• Manipulate and leverage multiple databases/Electronic Medical Records applications to sort, search, and enter information
• Identify incomplete/inconsistent information in medical records and label missing measures/metrics/concerns

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:

• Current and unrestricted Louisiana LPN License

   

• 2+ years of HEDIS and STARs measures experience
• 2+ years of health care industry experience
• Proven solid computer skills required including knowledge of Microsoft Word, Excel, and EPIC

Physical Demands/Working Conditions

• Must be able to lift 10-15 pounds and operate standard office equipment, computer, printer, fax and copier
• Must have dependable transportation and be able to travel periodically to all clinic locations

Core Competencies

• Sets priorities for work assignments and uses initiative in completion of tasks
• Professionalism
• Flexible
• Goal oriented
• Independent
• Team Player
• Excellent with follow-through and completion
• Enjoys working with detail and organization
• Produces highly accurate work
• Able to meet deadlines
• Solid verbal and written communication skills
• Ability to interface with multiple levels of the medical profession
• Understanding of the healthcare industry

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.