WellMed, part of the Optum family of businesses, is seeking a Clinical Practice Performance Coordinator to join our team in Corsicana, 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. 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.
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 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 coding practices
- Activities may include data collection, data entry, quality monitoring, health plan/WellMed form submission and chart collection activities
- Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures
- Support quality initiatives by requesting medical records from provider's offices as needed
- Receives and responds to incoming Clinical Quality inquiries from all communication venues: e.g. phone and fax queue, TruCare, or department e\-mail box
- Conducts in\-bound and out\-bound calls for quality requirements including, but not limited to: patient scheduling, medical records requests, contact verification
- Documents timely patient and clinic interactions of in\-bound and/or out\-bound calls into software applications
- Provides clerical and/or administrative support to quality staff and managers for special projects and reporting needs
- Provides excellent customer service by serving as a resource to all internal and external customers
- Maintains education/knowledge base of HEDIS/STARs
- Performs all other related duties as assigned
- High School Diploma or GED
- 2\+ years of administrative support experience
- Experience using Microsoft Office applications, including Excel, Word, and Outlook
- Ability to work independently, with some supervision and direction from manager
- Possesses medical terminology knowledge base
- Maintain strict confidentiality at all times
- Adhere to all department/ organizational policies and procedures
- 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
- Certified Medical Assistant training or certification
- 3\+ years of experience with data analysis/quality chart reviews
- 2\+ years of experience in a physician's clinic or hospital
- 1\+ years of HEDIS/STAR experience or participation with similar quality regulatory reporting
- Experience working in a medical care setting as a receptionist or medical assistant
- EMR and HEDIS knowledge and experience
- Excel and data mining experience
- Possess and demonstrate excellent organizational skills, customer service skills, to include verbal and written communication
- Maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
- Bilingual language proficiency (English/Spanish)
In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000\+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000\+ older adults. Together, we're making health care work better for everyone.
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:
Preferred Qualifications:
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far\-reaching choice of benefits and incentives. The hourly pay for this role will range from $20\.38 to $36\.44 per hour based on full\-time employment. We comply with all minimum wage laws as applicable.
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.