LVN/LPN Quality HEDIS/STARs Coordinator San Antonio Texas
Company: Optum
Location: Gonzales
Posted on: May 8, 2025
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Job Description:
-$1K Sign on Bonus for External Candidates
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WellMed, part of the Optum family of businesses, is seeking a
LVN/LPN Quality HEDIS/STARs Coordinator to join our team in San
Antonio, Texas. Optum is a clinician-led care organization that is
changing the way clinicians work and live.
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As a member of the Optum Care Delivery team, you'll be an integral
part of our vision to make healthcare better for everyone.
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At Optum, you'll have the clinical resources, data and support of a
global organization behind you so you can help your patients live
healthier lives. Here, you'll work alongside talented peers in a
collaborative environment that is guided by diversity and inclusion
while driving towards the Quadruple Aim. We believe you deserve an
exceptional career, and will empower you to live your best life at
work and at home. Experience the fulfillment of advancing the
health of your community with the excitement of contributing new
practice ideas and initiatives that could help improve care for
millions of patients across the country. Because together, we have
the power to make health care better for everyone. Join us and
discover how rewarding medicine can be while -Caring. Connecting.
Growing together.
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This position is responsible for the coordination of HEDIS and
STARs data. This role is responsible for education to the patient
on quality measures and coordinates strategies for closing gaps.
-The Quality Coordinator LVN, through telephonic outreaches will
educate patients on CAHPS & HOS components while working to close
other HEDIS gaps for patients. Evaluates the quality and
completeness of clinical gap closures by performing quality reviews
with patients, maintaining clinical documentation, and accurately
records of their review activities. The Quality Coordinator LVN
will maintain up-to-date knowledge of regulatory (HEDIS/STARs)
standards and guidelines.
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Position Highlights & Primary Responsibilities:
Analyze data, evaluate for possible data integrity and data
deficits and document findings
Analyze and trend HEDIS/STAR rates, identify barriers to
improvement of rates and create interpretive exhibits
Identifies patients with the missing measures and works to close
the measures through education/counseling, appointment setting, and
other means as appropriate
Conduct a high volume of outbound calls to members to discuss
reasons for non-compliant to medication(s), schedule pharmacy
telephonic appointments, and/or obtain important follow up
information from providers. Outbound calls are made primarily using
an auto dialer requiring precision to
detail and adaptability to type of response needed
May answer inbound calls from members and assists them with their
inquiries. Routes calls to appropriate department if necessary
Follows system scripting and validates member demographic
information
Documents the provider or member's record with accurate information
obtained on the call
Works closely with local leadership to execute quality
strategies
Supports and assists PCPs/clinics with quality data collection
Provides reports and monitors performance at local level
Engages PCP and clinic staff in developing strategies to close
quality gaps
Maintains education/knowledge base of HEDIS/STARs standards and
guidelines
Performs all other related duties as assigned
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-This is an office-based position located near Interstate Highway
I-10 West, near West Frontage Road just past The Rim Shopping
Center/Ferrari Dealership, 78257
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In 2011, WellMed partnered with Optum to provide care to patients
across Texas and Florida. WellMed is a network of doctors,
specialists and other medical professionals that specialize in
providing care for more than 1 million older adults with over
16,000 doctors' offices. At WellMed our focus is simple. We're
innovators in preventative health care, striving to change the face
of health care for seniors. WellMed has more than 22,000+ primary
care physicians, hospitalists, specialists, and advanced practice
clinicians who excel in caring for 900,000+ older adults. Together,
we're making health care work better for everyone.
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-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:
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
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Preferred Qualifications:
2+ years of college, in pursuance of a Bachelor's or Associate's
degree
2+ years of experience working with HEDIS/STAR measures
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The hourly range for this role is $19.86 to $38.85 per hour based
on full-time employment. Pay is based on several factors including
but not limited to local labor markets, education, work experience,
certifications, etc. UnitedHealth Group complies with all minimum
wage laws as applicable. 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.
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OptumCare -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.
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OptumCare is a drug-free workplace. Candidates are required to pass
a drug test before beginning employment.
Keywords: Optum, San Marcos , LVN/LPN Quality HEDIS/STARs Coordinator San Antonio Texas, Healthcare , Gonzales, Texas
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