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Job Discription
LVN Verification Specialist HEDIS San Antonio ( HEDIS and STARS Experience )
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. Must be able to review data and provide recommendations for improvement
- HEDIS/STAR experience or participation with similar regulatory reporting
- Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Primary Responsibilities:
- Analyze data, evaluate for possible data integrity and data deficits and document findings
- Over reads the data entry of non-standard supplemental data obtained from medical record review
- Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures
- Review of scanned records and data entry into DataRaps application
- Support chart chase process by requesting records from provider’s offices as needed
- Supports and improves communications between market and corporate departments
- 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.
