Practice Performance Specialist

UnitedHealth Group • Greenville, SC

148d • $20 - $35 • Onsite

About The Position

This position is Field Based and requires regular travel to various locations as part of your daily responsibilities. 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This position is full-time (40 hours/week) 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. We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Requirements

• High School Diploma / GED
• Must be 18 years of age OR older
• 1+ years of customer service experience within healthcare, insurance, social services, education, or government/state agencies.
• 1+ years of working experience with Microsoft Word (create, modify, and send documents)
• 1+ years of working experience with Microsoft Outlook (create, modify, and send emails)
• Must possess a valid driver's license and provide proof of insurance.
• Ability to work remotely and travel up to 50% to local healthcare providers as needed.
• Reside within a commutable distance of Greenville, SC.
• Ability to work full-time Monday - Friday.

Nice To Haves

• Experience working in a physician, provider, and/or medical office
• Experience with navigating, filtering, and analyzing reports in Microsoft Excel
• 1+ year of working experience with ICD- 9/10 and CPT Codes.
• 1+ year of working experience with and knowledge of HIPAA compliance requirements.
• Medical Assistant experience
• LPN
• 1+ years of telephonic customer service experience
• EMR and HEDIS knowledge and experience

Responsibilities

• Assist in the review of medical records to highlight Star opportunities for the medical staff.
• Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities.
• Locate medical screening results/documentation to ensure quality measures are followed in the closure of gaps.
• Track appointments and document information completely and accurately in all currently supported systems in a timely manner.
• Optimize customer satisfaction, positively impact the closing of gaps in care and productivity.
• Partner with your leadership team, the practice administrative or clinical staff to determine the best strategies to support the practice and our members ensuring that recommended preventative health screenings are completed and HEDIS gaps in care are addressed.
• Interaction with UHC 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.
• Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs.
• 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 virtual setting.
• Identify and seek out opportunities within one's own work flow to improve call efficiency.
• Adhere to corporate requirements related to industry regulations/responsibilities.
• Maintain confidentiality and adhere to HIPAA requirements.
• Data analysis required for multiple system platforms to identify open quality opportunities to address on a member or provider level.
• Appointment coordination for specialist appointments, late to refill medication outreach and scheduling members for local market clinic events.
• Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts.
• Field based activities require the abilities to support appropriate targeted providers.
• Other duties, as assigned.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED