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Field Based Clinical Quality Coordinator

3 months ago

Rio Rancho, United States Optum Full time

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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

The Clinical Quality Coordinator will be provider facing and participate in quality improvement initiatives in their assigned territory. This position works collaboratively with the market team in a matrix relationship and is responsible for the collection of medical records that support HEDIS and Stars activities and quality improvement initiatives.

This position is full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at Albuquerque, NM.

We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

Primary Responsibilities:

  • Activities include medical record review, data collection, data entry, quality monitoring, and chart collection activities to close quality gaps in care and improve Star/HEDIS performance
  • Partner with the Clinical Quality, Network Management and Risk Education teams to identify trends and potential strategies to support assigned practices
  • Track and trend barriers and challenges that exist within the assigned territory so that better outcomes can be achieved
  • Navigate multiple documentation systems (EMRs) and obtain medical records to improve quality and HEDIS/Star performance
  • Maintains education/knowledge base of HEDIS/STARs
  • Performs 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:

  • High School diploma / GED
  • Must be 18 years of age or older
  • 2+ years of healthcare experience in provider and patient-facing interactions
  • 1+ years of quality chart review and abstraction experience. Must be able to review data and provide recommendations for improvement.
  • Experience and proficiency using Microsoft Office applications, including Microsoft Outlook, Microsoft Word, Microsoft PowerPoint, and Microsoft Excel spreadsheets
  • Up to 75% local travel and valid NM Driver’s License 
  • Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm.

Preferred Qualifications:

  • 1+ years of experience in HEDIS/STARS
  • ICD 10 and CPT coding experience
  • Experience working in a physician, provider, and/or medical office
  • EMR and HEDIS knowledge and experience

Physical and Work Environment: 

  • Ability to lift up to 10 pounds
  • Ability to push or pull heavy objects
  • Ability to sit for extended periods of time
  • Ability to stand for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery Ability to properly drive and operate a vehicle
  • Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex problem solving

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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