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Clinical Quality LPN

Job in Eden Prairie, Hennepin County, Minnesota, 55344, USA
Listing for: UnitedHealth Group
Full Time position
Listed on 2026-03-08
Job specializations:
  • Healthcare
    Healthcare Administration
Salary/Wage Range or Industry Benchmark: 20.38 - 36.44 USD Hourly USD 20.38 36.44 HOUR
Job Description & How to Apply Below
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start  
** Caring. Connecting. Growing together.*
* The Clinical Quality LPN is responsible for Primary Source Verification and Supplemental Data Entry. They assist with the coordination of HEDIS® and STARs data gathering within Pathway, Ubiquity, XLCare, eHouse

Calls, and other applications as needed. This role evaluates the quality and completeness of clinical documentation, by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, maintaining accurate records of review activities, ensuring all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records. This role supports end of year final push activities, as well as hybrid chart chase processes.

You'll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges.

For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

*
* Schedule:

** Monday - Friday, 8:00 a.m.

- 5:00 p.m. in your time zone

*
* Primary Responsibilities:

*
* + Review and abstract medical record data into appropriate application(s)

+ Support chart chase processes by requesting/obtaining records as needed

+ Primary source verify abstracted medical record data

+ Analyze chart data, evaluate for possible data integrity and/or data deficits and document findings

+ Provide education and feedback to abstractors

+ Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures

+ Support chart chase processes by requesting records from provider offices as needed

+ Support member outreach campaigns within the H&C organization, as needed

+ Maintain education/knowledgebase of HEDIS®/STARs standards and guidelines

+ Assist team with re-training

+ Perform all other related duties as assigned

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.

*
* Required Qualifications:

*
* + Licensed Professional/Vocational Nurse

+ 3+ years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement

+ 2+ years of HEDIS/STAR experience or participation with similar regulatory reporting

+ Proven excellent communication practices, both oral and written

+ Experience using Microsoft office applications, including databases, word-processing, and Excel spreadsheets

*
* Preferred Qualifications:

*
* + Associate degree

+ Undergraduate degree or equivalent experience

+ Certified Professional Coder

+ Training experience

+ Ability to be flexible in a continuously changing environment

* All employees working remotely will be required to adhere to United Health Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Final date to receive applications:
This will be posted for a minimum of 2 business days or until a sufficient…
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