LVN Clinical Quality Consultant in Corpus Christi Texas

Optum • Corpus Christi, TX

395d

About The Position

The LVN Clinical Quality Consultant at WellMed, part of the Optum family, is responsible for coordinating the HEDIS and STARs data gathering process within a clinical setting. This role focuses on educating clinics about quality measures, evaluating clinical documentation processes, and developing training programs to improve care quality. The consultant will analyze data, identify barriers to improvement, and engage with local leadership and clinic staff to implement quality strategies, ultimately contributing to better healthcare outcomes for patients.

Requirements

• 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
• Ability to travel 50-75% locally
• Access to reliable transportation and valid TX driver's license

Nice To Haves

• 2+ years of college, in pursuance of a Bachelor's or Associate's degree
• 2+ years of experience working with HEDIS/STAR measures

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
• Obtain quality detail report and flag patient's charts with the missing measures
• Work closely with local leadership to execute quality strategies
• Support and assist PCPs/clinics with quality data collection
• Provide reports and monitor performance at local level
• Engage PCP and clinic staff in developing strategies to close quality gaps
• Support and improve communications between market and corporate departments
• Maintain education/knowledge base of HEDIS/STARs standards and guidelines
• Perform all other related duties as assigned

Benefits

• Competitive salary
• Health insurance
• Paid time off
• Professional development opportunities
• Diversity and inclusion programs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Associate degree
• Number of Employees: 10,001+ employees