LVN Case Manager Job at Heritage Victor Valley Medical Group, Victorville, CA

  • Heritage Victor Valley Medical Group
  • Victorville, CA

Job Description

Primary Job Duties and Responsibilities:

  • Engages physicians and office staff to facilitate discussions on HEDIS Part C Part D measures.
  • Performs medical record reviews, abstraction and data-entry for HEDIS as part of HEDIS operations to close GAPs in care.
  • Prepares reports and presentations outlining progress findings, and recommendations for management or regulatory bodies.
  • Conducts monthly reviews in a timely manner and in accordance with established guidelines.
  • Tracks compliance issues, trend data, prepares regular reporting to enhance performance related to HEDIS measures, and distributes to providers and internal teams.
  • Stays informed about the HEDIS/STAR rating requirements and applicable annual updates.
  • Prepares, submits, and bill findings to external stakeholders, ensuring adherence to reporting deadlines.
  • Presents a summary of all tracking reports to identify areas of improvement monthly or upon request.
  • Road travel required - 25% (Victor Valley surrounding cities)
  • Performs other related duties as assigned.
The pay range for this position at commencement of employment is expected to be between $27.66 and $29.07/hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this

Qualifications:
  • Education: High School graduate
  • Education: Graduate from an accredited school for Vocational Nurses.
  • Licensure: Current California LVN license.
  • Experience: One year experience with HEDIS/STAR, medical records review.
  • Knowledge: Required computer applications Excel, Word, Outlook, Power Point.
  • Able to work in a multi-task, high demand environment.
  • Driving: Driver's License and proof of Auto Insurance.
  • Position is onsite.

Job Tags

Work at office

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