For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The Senior Clinical Quality RN will be the primary person responsible for conducting medical record review to support required HEDIS and quality improvement activities. This person will work with the well trained HEDIS data collection team of nurses to oversee timely and accurate data collection and interrater reliability testing. Primary Responsibilities:Perform HEDIS medical record review in physician offices throughout the state of Nevada Complete inter-rater reliability testing and required computer training successfully in order to complete this data collection Conduct additional QI audits through medical record review Help with credentialing activities for organizations and facilities such as hospitals and skilled nursing facilities Educates Physicians, RNs and other clinical employees in the off season
Required Qualifications:Current unrestricted RN license in the state of Nevada 2+ years Clinical Quality experience Previous experience educating Physicians, RNs or other clinical and / or non-clinical employees Electronic Medical Records (EMR) experience Must be self-motivated and able to learn new computer software quickly Must be comfortable and proficient in being trained on a data collection software that allows the person to collect and record medical record information accurately on a timely basis Ability to demonstrate knowledge and to apply to job functions, those state and federal laws and regulations applicable to the operation unit Skilled in use of computers including MS Windows, Excel, Word and PowerPoint Preferred Qualifications:Bachelor's Degree Previous HEDIS data collection and medical record / chart review experience highly preferred Medical Record Audit Experience a Plus (medical record review and capturing / documenting appropriate clinical information needed to assure compliance) 2+ years Clinical Quality experience in acute care or managed care settingCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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: Registered Nurse, Nurse, RN, Quality, Quality Improvement, Analyst, Health Care, Medicaid, Medicare, HEDIS, STARS, NCQA, Managed Care, Utilization Management, Quality, Clinical Practice Consultant, Regulatory Compliance, CMS, Clinical, Project Manager, Las Vegas, NV, Nevada, UHC, UnitedHealthcare
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.