Clinical Practice Performance Coordinator - North Richland Hills, TX

WellMed, part of the Optum family of businesses, is seeking a Clinical Practice Performance Coordinator to join our team in North Richland Hills, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

This position is responsible for the coordination of HEDIS and STARs data gathering process. This evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, identifying trends, maintaining accurate records of review activities, ensuring all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records.

The Clinical Quality Coordinator will have a duty to provide a standard of care that meets or exceeds that of a reasonably competent and knowledgeable Medical Assistant.

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 8am - 5pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at 4300 City Point Dr., Suite 201, North Richland Hills, TX 76180.

We offer 2 - 3 weeks of paid training. The hours during training will be 8am-5pm CST, Monday - Friday.

Primary Responsibilities:

• Assisting in the review of medical records to highlight Star/HEDIS opportunities for the medical staff.
• Review medical records for data collection, data entry, and quality monitoring including health plan/WellMed form submission and chart collection activities that close gaps in care.
• Partner with the leadership team, the practice administrative or clinical staff to identify trends observed and potential strategies to support the practice.
• Communicate scheduling challenges or trends that may negatively impact quality outcomes.
• Track and trend barriers/challenges that exist at their assigned groups so that better outcomes can be achieved including access to appointments, lack of follow-up on referrals, or inconsistent billing practices.
• Activities may include data collection, data entry, quality monitoring, health plan/WellMed form submission and chart collection activities.
• Assists with local IRR audits.
• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures.
• Support chart chase process by requesting records from provider's offices as needed.
• 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 directions 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
• Medical Assistant certification
• Must be at least 18 years of age or older
• 2+ years of experience as a Certified Medical Assistant
• 3+ years of healthcare experience including experience in a managed care setting
• 3+ years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement.
• Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets.
• BLS certification
• Ability to mentor others
• Expert in computer literacy in electronic health record
• Knowledge of medical terminology
• This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease.
• Ability to work full time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Licensed Vocational/Registered Nurse, or Certified Professional Coder
• 1+ years of HEDIS/STAR experience or participation with similar regulatory reporting.
• 2+ years of experience working with HEDIS/STAR measures.
• ICD 9/10 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 using up to 50 pounds of force
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate equipment and/or machinery
• Ability to properly drive and operate a company vehicle
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving
• Occasionally requires exposure to communicable diseases or bodily fluids

The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

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