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Clinical Quality Specialist
2 months ago
At Optum, we're dedicated to delivering care and improving health outcomes for millions of people worldwide. As a Clinical Quality Coordinator, you'll play a critical role in our mission by working collaboratively with our market team to drive quality improvement initiatives in your assigned territory.
Key Responsibilities:- Collect and review medical records to support HEDIS and Stars activities, ensuring accurate data collection and entry.
- Partner with our Clinical Quality, Network Management, and Risk Education teams to identify trends and develop strategies to improve quality and performance.
- Track and analyze barriers and challenges in your assigned territory to inform data-driven decisions and drive better outcomes.
- Navigate multiple documentation systems to obtain medical records and improve quality and performance.
- Stay up-to-date on HEDIS and Stars requirements, ensuring our practices meet the highest standards.
- High school diploma or equivalent required; 2+ years of healthcare experience in provider and patient-facing interactions.
- 1+ year of quality chart review and abstraction experience, with the ability to analyze data and provide recommendations for improvement.
- Proficiency in Microsoft Office applications, including Outlook, Word, PowerPoint, and Excel.
- Valid NM driver's license and ability to travel up to 75% locally.
- 1+ year of experience in HEDIS/STARS; ICD 10 and CPT coding experience a plus.
- EMR and HEDIS knowledge and experience a strong asset.
We offer a comprehensive benefits package, including weeks of on-the-job training, to support your growth and development. If you're passionate about improving healthcare outcomes and working collaboratively with our team, we encourage you to apply for this exciting opportunity.
