Quality Coordinator – Irving, TX

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.

This position is full time  Monday – Friday. 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. Employees are required to work some days onsite and some days from home.

We offer 6-8 weeks of paid training. The hours during training will be 8:00am to 5:00pm CST, Monday – Friday. 

If you are within commutable distance to the office at 909 Hidden Ridge Irving, TX and East Dallas TX you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

        

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 direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualification:

• High School Diploma / GED
• Must be 18 years of age OR older
• 1+ years of healthcare experience to include experience in a managed care setting
• Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets
• Ability to work Monday – Friday. 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

           

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
• 3+ years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement
• Experience with ICD 10 and CPT coding  
• Experience working in a physician, provider, and/or medical office 
• EMR and HEDIS knowledge and experience

      

Telecommuting Requirements:

• Reside within commutable distance to the office at 909 Hidden Ridge Irving, TX and East Dallas TX
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

      

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 receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving

       

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy  

 

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.

 

 

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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