Licensed Vocational Nurse, LVN/LPN, HEDIS/ STARS - San Antonio, TX

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Licensed Vocational Nurse, LVN/LPN, HEDIS/ STARS - San Antonio, TX - 694721

Position Description

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)


This position is responsible for the Primary Source Verification process and coordination of HEDIS and STARs data gathering process within the eCW and DataRaps applications. This role evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records.


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


To be considered for this position, applicants need to meet the qualifications listed in this posting.

Required Qualifications:

  • 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 Qualifications:

  • Two or more years of college, in pursuance of a Bachelor’s or Associate’s degree
  • Two or more years of experience working with HEDIS/STAR measures

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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: WellMed, Healthcare, Bilingual, Licensed Vocational Nurse, LVN/LPN, Primary Source Verification Process, HEDIS/STAR, Consultant, San Antonio, New Braunfels, Seguin, Gonzales, Shiner, Yoakum, Boerne, Floresville, Helotes, Texas, TX

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Job Details
Contest Number: 694721
Job Title: Licensed Vocational Nurse, LVN/LPN, HEDIS/ STARS - San Antonio, TX
Job Family: Nursing
Business Segment: OptumCare
Job Location Information:
Region: North America
Country: United States
City: San Antonio
State/Province: Texas
Other States where Job(s) is Located: TX,TX,TX,TX,TX
Other Cities where job(s) is Located: ,NEW BRAUNFELS,SEGUIN,Gonzales,BOERNE
Additional Job Detail Information:
Employee Status: Regular
Schedule: Full-time
Job Level: Individual Contributor
Shift: Day Job
Travel: No
Telecommuter Position: No
Overtime Status: Non-exempt