Clinical Performance Coordinator

1 week ago


Kinston, North Carolina, United States Optum Full time
About the Role

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.

This position is a full-time opportunity that requires flexibility to work any of our 8 hour shift schedules during our normal business hours.

Field-based activities require the ability to support targeted providers and participate in department campaigns to improve overall quality improvements within measure star ratings or contracts.

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.

Key Responsibilities
  • Assist in the review of medical records to highlight opportunities for improvement.
  • Collect and enter data, monitor quality, upload images, and collect charts.
  • Locate medical screening results/documentation to ensure quality measures are followed.
  • Track appointments and document information completely and accurately in all supported systems.
  • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity.
  • Partner with leadership, practice administrative or clinical staff to determine strategies to support the practice and our members.
  • Interact with members via telephone to assist and support an appropriate level of care.
  • Answer inbound calls from members and/or providers regarding appointments.
  • Communicate scheduling challenges or trends that may negatively impact quality outcomes.
  • Provide ongoing support and education to team members and assist in removing barriers in care.
  • Manage time effectively to ensure productivity goals are met.
  • Ability to work independently in a virtual setting and problem solve to resolve issues.
  • Identify and seek out opportunities to improve call efficiency.
  • Adhere to corporate requirements related to industry regulations and responsibilities.
  • Maintain confidentiality and adhere to HIPAA requirements.
  • Data analysis required for multiple system platforms to identify open quality opportunities.
  • Appointment coordination for specialist appointments, late refill medication outreach, and scheduling members for local market clinic events.
Requirements
  • High School Diploma / GED
  • 18 years or older
  • 2+ years of telephonic customer service experience
  • 1+ years of healthcare background with medical terminology and clinical issues familiarity
  • 1+ years of working experience with ICD- 9/10 and CPT Codes
  • 1+ years of working experience with knowledge of HIPAA compliance requirements
  • Microsoft Tools: Microsoft Word, Microsoft Outlook, and Microsoft Excel
  • Ability to travel up to 75% of the time within the Greenville, NC area
  • Reside within commutable distance of Greenville, NC
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection
Preferred Qualifications
  • 1+ year experience as a pharmacy tech
  • Experience working in a physician, provider, and/or medical office
  • Medical Assistant
  • LPN
  • EMR and HEDIS knowledge and experience
  • Pharmacy tech license
Soft Skills
  • Strong data entry skills, with a typing speed of at least 45-50 WPM
  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities
  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect
  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve goal(s)
  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
  • Good Attendance Record


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