Quality Medical Assistant MA WellMed Plano Texas

UnitedHealth Group•Frisco, TX

8h•Onsite

About The Position

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind 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, ensures 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.

Requirements

High School diploma or GED
Sustained Medical Assistant certification
Current BLS certification
3+ years of healthcare experience to include 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
2+ years as a Certified Medical Assistant
Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets
Proven 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

Nice To Haves

Licensed Vocational/Registered Nurse, or Certified Professional Coder
1+ years of HEDIS/STAR experience or participation with similar regulatory reporting.
2+ years of college, in pursuance of a Bachelor’s or Associate’s degree.
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 is preferred.
EMR and HEDIS knowledge and experience

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

Benefits

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.

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