Quality Liaison LVN

One Community. One Mission. One California

As our Quality Liaison LVN you will educate and support providers and practice sites in improving clinical quality measures and closing gaps in care. You can expect to travel to provider sites and clinics 50%-75% of the workweek.

Every day you will advise and educate providers and practice staff in clinical quality measures medical record documentation and coding guidelines. You will collect summarize and trend provider performance data to identify opportunities for provider improvement and closing gaps-in-care.

To be successful in this role you will have a deep understanding of HEDIS measures exceptional communication skills and a high level of attention to detail for chart reviews data collection data entry and reporting.

As a remote employee we will provide you with the equipment needed to work from home including a laptop docking station dual monitors and accessories.

This position will be work from home for residents of CA ideally in Central Valley or Ventura regions due to onsite presence needed in the provider clinics.

• Advises and educates providers and practice staff in clinical quality measures medical record documentation and coding guidelines. Collects summarizes and trends provider performance data to identify opportunities for provider improvement and closing gaps-in-care.
• Reports provider/clinic specific metrics. Identifies specific practice needs and barriers to clinical quality improvement. Develops action plans to address the needs and barriers in collaboration with providers.
• Performs medical record review or audits as needed. Document provider clinic staff member and/or health plan encounters.
• Partners with physicians/physician staff to find ways to explore new ways to encourage member clinical participation in wellness and education. Provides resources on clinical quality measures to support providers and clinic staff.
• Update data and maintain data integrity in the population health platforms and EHR systems.

• Two (2) years related HEDIS record collection and measures improvement with analytical review/evaluation and / or Quality Improvement
• Experience in data and chart reviews to provide consultation and education to providers and provider staff
• Clear and current CA Licensed Vocational Nurse (LVN) license
• Demonstrated skills in the areas of written and verbal communication judgment problem-solving presentation and public relations

Preferred

• Knowledge of front and back office workflows in provider offices preferred
• Associates degree in Healthcare Public Health Nursing Psychology Health Administration Social Work or related field preferred
• 1 year of experience in Managed Care preferred