Job Title : Clinical Quality LPN
Location : San Antonio - TX
Contract : 3-months assignment with possible extension.
Shift Timing : 08 : 00 AM 05 : 00 PM CST (Monday to Friday)
Hours Per Week : 40 hours per week
What is the top 5-10 responsibilities for this position :
- 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 assist 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.
Please describe the team the candidate will be working with (number of team members break-down of the teams skill sets team culture etc.) : Team of 30- (24 LVN / LPN) (3 CTAs) (2 Sups) (1 BA) (1 director)
What does the ideal candidate background look like : Someone detail-oriented familiar with multiple computer programs at once who can document while on call with member or provider
Minimum Required Education, Experience & Skills :
Licensed Vocational / Professional Nurse.Prior HEDIS / STAR experience or participation with similar regulatory reporting.Three or more years of healthcare experience to include experience in a managed care setting.Three or more years of experience with data analysis / quality chart reviews.Must be able to review data and provide recommendations for improvement.Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets.Preferred Education, Experience & Skills :
Two or more years of college, in pursuance of a bachelors or associate degree.Two or more years of experience working with HEDIS / STAR measures.Does this position require a professional license or certification If so, please list : Current Unrestricted LVN license in state of Texas.
What is the dress code (ex : business casual scrubs etc.) : business casual
How would you prefer to interview (Video phone or in person and how many rounds) : video or in person- 1 round
In case, you are interested in the opportunity, kindly forward your updated resume along with contact information at Pjoshi@judge.com or you can Call or Text me at (610)-423-1961.