Description
Under the direction of the Quality Programs Director, the Quality Programs LVN Case Manager plays a key role in supporting HEDIS and quality reporting initiatives, ensuring healthcare providers excel in meeting Quality Measures consistent with the CMS Star Rating Program. This role is responsible for ensuring the accuracy, completeness, and compliance of medical record abstraction and data validation processes that impact HEDIS measure performance, regulatory audits, and quality improvement efforts. The Quality Programs LVN Case Manager reviews medical records across various provider EMR systems, Paper charts repositories, and accurately documents findings and ensures adherence to technical specifications. Additional responsibilities include contributing to departmental workflows, supporting annual training, and advancing broader quality initiatives. This position will require strong organization, communication skills, and feedback to achieve maximum CMS Star Ratings every year. Assists with other clerical duties as required.