LVN Lead - Quality & Grievances (HEDIS & QA)

Universal Health Services; Riverside (CA); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Challenging and rewarding work environment

Competitive compensation and paid time off

Medical, Dental, Vision and Life Insurance Plans

401(K) with company match

Job summary

A leading healthcare provider in Riverside seeks a Quality Coordinator to oversee health plan reports, coordinate annual audits, and handle grievances and appeals. Candidates should possess an associates degree and a California LVN license, with strong knowledge of patient rights, electronic health records, and quality initiatives. The role requires leadership in quality audits and education on compliance. Competitive compensation, benefits, and a supportive work environment are offered.

Qualifications

• Strong knowledge of Patients rights and responsibilities required.
• Familiarity with electronic health records (EHR) preferred.
• Experience with grievances and appeals management is crucial.

Responsibilities

• Prepare Health Plan required reports and coordinate annual audits.
• Conduct annual medical record audits on practitioners.
• Review and respond to grievances and appeals in a timely manner.

Skills

Knowledge of Patients rights and responsibilities

Familiarity with electronic health record (EHR)

Skilled in coordinating case reviews

Ability to develop and monitor quality initiatives

Education

Associates degree from an accredited college or University

Current California LVN License

Job description

A leading healthcare provider in Riverside seeks a Quality Coordinator to oversee health plan reports, coordinate annual audits, and handle grievances and appeals. Candidates should possess an associates degree and a California LVN license, with strong knowledge of patient rights, electronic health records, and quality initiatives. The role requires leadership in quality audits and education on compliance. Competitive compensation, benefits, and a supportive work environment are offered.