Senior Clinical Practice Performance Coordinator

UnitedHealth Group Inc.•Jackson, MS

29d•$23 - $42•Hybrid

About The Position

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. If you live near Jackson, MS, you will enjoy the flexibility of a hybrid-remote position as you take on some tough challenges. This position follows a hybrid schedule with three in-office days per week.

Requirements

High School Diploma/GED (or higher)
2+ years of telephonic customer service experience
1+ years of healthcare experience with medical terminology familiarity with clinical issues
1+ years of experience/knowledge of HIPAA compliance requirements
Intermediate level of knowledge/experience with Microsoft Tools: Word, Outlook, and Excel
Strong data entry skills, with a typing speed of at least 45-50 WPM
Ability to travel 60% of the time for business meetings (including client/health plan partners and provider meetings) and 40% remote work
Must have a valid US driver's license

Nice To Haves

1+ years of working experience with ICD- 9/10 and CPT Codes
Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities
Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect
Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s)
Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
Good Attendance Record
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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. Will not conduct any evaluation or interpretation of Clinical data
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. This may include making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care or chart collection activities
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. Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise
Identify and seek out opportunities within one's own workflow 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
Work internally with support team on ad-hoc projects, initiatives, and sprints to address measure star ratings and increase overall measure performance
Participate and engage with team on member or provider campaigns which may include documentation tracking, member outreach, data analysis and data entry
Support incentive account owners on strategy development, feedback and participate within monthly meetings to give updates on member outreach or quality measure closures
Support EMR data exchange initiatives with incentive program owner to establish data communication between provider group and UHC
Weekly commitment of 60% travel for business meetings (including client/health plan partners and provider meetings) and 40% remote work
Other duties, as assigned