Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
The Quality LVN is responsible for providing telephonic support and resources utilizing approved protocols per department’s policy. This role will be working in a call center environment under supervision, must be able to work independently and seek guidance from the Registered Nurse as needed. This position handles inbound and outbound calls from patients, patient representatives, providers and other medical staff. Practicing quality clinical skills and strictly adhering to established protocols, handles patient inquiries and requests and works closely with
This function also assists callers with general contacts including, but not limited to, appointment scheduling, general facility and provider information, general requests, medical records requests and issue resolution. Works collaboratively with clinic staff and other departments to provide an exceptional patient experience.
*** You will be working in our brand new and beautiful building located at The Rim. On-site cafeteria, gym and health clinic!***
- Strictly adheres to department’s metrics and established advanced protocols and to handle incoming contacts including, but not limited to, prescription refill requests, lab results, x-ray results, medical inquiries, patient education and referral requests
- Primarily to make inbound and outbound calls but occasionally help manage the inbound call que from patients, patient representatives, providers and other medical staff, while strictly adhering to established protocols and scripting
- Verify and update patient information in the clinical information system
- When appropriate, assigns electronic tasks to clinic staff to intervene with medically related inquiries and requests and to address concerns
- Review patient chart (in EMR) to ensure core measures are being addressed and met per protocol and takes appropriate action when they are not, i.e., schedule services
- Assist patients with identification of and connectivity to community and program resources to assist with non-medical needs, (Pharmacy assistance programs, meals on wheels, LIS)
- Document thoroughly all calls and actions taken within core systems
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.
- High School Diploma or GED or higher
- Unrestricted Texas or LVN compact license
- 2+ years of experience in HEDIS/Star or Quality related programs
- 2+ years of healthcare experience, including experience in a managed care setting
- Experience using Microsoft office applications, including databases, word-processing and excel spreadsheets
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
- 2+ years of experience working with HEDIS/STAR measures
- Call Center experience
- Solid computer experience (data entry, multi-screen navigation, keyboarding)
- Bilingual (English and Spanish)
- Proven ability to work effectively in a fast-paced call center environment
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
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 550,000+ 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)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.