Clinical Quality RN - Telecommute in EST or CST Time Zones
Company: UnitedHealth Group
Location: Minnetonka
Posted on: May 12, 2022
Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that is
improving the lives of millions. Here, innovation is not about
another gadget; it is about making health care data available
wherever and whenever people need it, safely and reliably. There is
no room for error. If you are looking for a better place to use
your passion and your desire to drive change, this is the place to
be. It's an opportunity to do your life's best work.(sm)The
Clinical Quality RN is a subject matter expert for Primary Source
Verification and Supplemental Data Entry. They assist with the
coordination of HEDIS - and STARs data gathering within Cozeva,
DataRAP and other applications as needed. This role evaluates the
quality and completeness of clinical documentation, by performing
quality medical record reviews, assisting in the improvement of the
clinical documentation process, maintaining accurate records of
review activities, ensuring all data submitted to the health plan
meets the HEDIS -/Star technical specifications for medical
records. This role assists the Supervisor of Quality Operations
with over reads and quality assurance checks.If you are located in
EST or -CST, -Time Zones, you will have the flexibility to
telecommute* as you take on some tough challenges. -Primary
Responsibilities:
- Review and abstract medical record data into appropriate
application(s)
- Primary source verify abstracted medical record data
- Over read abstracted and verified medical record data
- Analyze chart data, evaluate for possible data integrity and/or
data deficits and document findings
- Provide education and feedback to primary source verifiers
and/or abstractors
- Support chart chase processes by requesting records from
provider offices as needed
- Navigate multiple documentation systems and obtain medical
record sections supportive of HEDIS/Star measures
- Support and improve communications between market and corporate
departments
- Maintain education/knowledge base of HEDIS -/STARs standards
and guidelines
- Assist with process improvement
- Performs all other related duties as assignedYou'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:
- Associate degree
- Registered Nurse
- 3+ years of experience with data analysis/quality chart
reviews. Able to review data and provide recommendations for
improvement
- 2+ years of HEDIS -/STAR experience
- Experience using Microsoft office applications, including
databases, word-processing, and Excel - spreadsheetsPreferred
Qualifications:
- Undergraduate degree
- Certified Professional Coder
- 1+ years of process improvement experience
- Experience in training and excellent presentation skills
- Ability to be flexible in a continuously changing
environment
- Excellent communication practices, both oral and written
- Full COVID-19 vaccination is an essential requirement of this
role. UnitedHealth Group will adhere to all federal, state and
local regulations as well as all client requirements and will
obtain necessary proof of vaccination prior to employment to ensure
compliancePhysical and Mental Requirements:
- Ability to lift up to 25 pounds
- Ability to sit for extended periods of time
- Ability to use fine motor skills to operate office equipment
and/or machinery
- Ability to receive and comprehend instructions verbally and/or
in writing
- Ability to use logical reasoning for simple and complex problem
solvingTo protect the health and safety of our workforce, patients
and communities we serve, UnitedHealth Group and its affiliate
companies now require all employees to disclose COVID-19
vaccination status prior to beginning employment. In addition, some
roles require full COVID-19 vaccination as an essential job
function. UnitedHealth Group adheres to all federal, state and
local COVID-19 vaccination regulations as well as all client
COVID-19 vaccination requirements and will obtain the necessary
information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employment.Careers with Optum.
Here's the idea. We built an entire organization around one giant
objective; make health care work better for everyone. So when it
comes to how we use the world's large accumulation of
health-related information, or guide health and lifestyle choices
or manage pharmacy benefits for millions, our first goal is to leap
beyond the status quo and uncover new ways to serve. Optum, part of
the UnitedHealth Group family of businesses, brings together some
of the greatest minds and most advanced ideas on where health care
has to go in order to reach its fullest potential. For you, that
means working on high performance teams against sophisticated
challenges that matter. Optum, incredible ideas in one incredible
company and a singular opportunity to do your life's best
work.(sm)Colorado, Connecticut or Nevada Residents Only: The hourly
range for Colorado residents is $21.68 to $38.56. The hourly range
for Connecticut/Nevada residents is $23.94 to $42.40. Pay is based
on several factors including but not limited to education, work
experience, certifications, etc. In addition to your salary,
UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice
of benefits and incentives.*All Telecommuters will be required to
adhere to UnitedHealth Group's Telecommuter Policy.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: Clinical Quality RN, RN,
HEDIS, STARS, Extraction, Telecommute, Telecommuting, Telecommuter,
Work From Home, Work At Home, Remote, - -Central Time, CST, EST,
Eastern Time
Keywords: UnitedHealth Group, Minnetonka , Clinical Quality RN - Telecommute in EST or CST Time Zones, Healthcare , Minnetonka, Minnesota
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