UnitedHealth Group
- Cleburne, TX
- Permanent
- Full-time
MA Certification Fee Reimbursement – 401 K Match
Do you have empathy and an enthusiasm to assist others? Changing health care and countless lives as an outcome begins with the worths you welcome and the enthusiasm you give accomplish your life’s finest work.( sm)
This position is accountable for the coordination of HEDIS and STARs information event procedure. This examines the quality and efficiency of scientific documents procedures by carrying out quality medical record evaluations, helping in the enhancement of the medical paperwork procedure, recognizing patterns, preserving precise records of evaluation activities, guarantees all information sent to the health insurance satisfies the HEDIS/Star technical requirements for medical records. The Clinical Quality Coordinator will have a responsibility to supply a requirement of care that satisfies or surpasses that of a fairly skilled and educated Medical Assistant.
Primary Responsibilities:
- Assisting in the evaluation of medical records to highlight Star/HEDIS chances for the medical personnel
- Review medical records for information collection, information entry, and quality tracking consisting of health plan/WellMed type submission and chart collection activities that close spaces in care
- Partner with the management group, the practice administrative or medical personnel to determine patterns observed and possible methods to support the practice
- Communicate scheduling difficulties or patterns that might adversely affect quality results
- Track and pattern barriers/challenges that exist at their designated groups so that much better results can be accomplished consisting of access to consultations, absence of act on recommendations, or irregular billing practices
- Activities might consist of information collection, information entry, quality tracking, health plan/WellMed kind submission and chart collection activities
- Assists with regional IRR audits
- Navigate several documents systems and acquire medical record areas helpful of HEDIS/Star procedures
- Support chart chase procedure by asking for records from supplier’s workplaces as required
- Maintains education/knowledge base of HEDIS/STARs
- Performs all other associated responsibilities as designated
You’ll be rewarded and acknowledged for your efficiency in an environment that will challenge you and offer you clear instructions on what it requires to prosper in your function in addition to offer advancement for other functions you might have an interest in.
Required Qualifications:
- High School diploma or GED
- Sustained Medical Assistant accreditation
- Current BLS accreditation
- 3+ years of health care experience to consist of experience in a handled care setting
- 3+ years of experience with information analysis/quality chart evaluations. Need to have the ability to examine information and offer suggestions for enhancement
- 2+ years as a Certified Medical Assistant
- Experienced utilizing Microsoft workplace applications, consisting of databases, word-processing, and stand out spreadsheets
- Expert in computer system literacy in electronic health record
- Knowledge of medical terms
- Proven capability to coach others
- This position needs Tuberculosis screening in addition to evidence of resistance to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through laboratory verification of resistance, recorded proof of vaccination, or a physician’s medical diagnosis of illness
- Full COVID-19 vaccination is an important task function of this function. Prospects situated in states that mandate COVID-19 booster dosages need to likewise adhere to those state requirements. UnitedHealth Group will stick to all federal, state and regional guidelines along with all customer requirements and will get essential evidence of vaccination, and boosters when appropriate, previous to work to make sure compliance. Prospects should have the ability to carry out all vital task functions with or without sensible lodging
Preferred Qualifications:
- Licensed Vocational/Registered Nurse, or Certified Professional Coder
- 2+ years of college, in pursuance of a Bachelor’s or Associate’s degree
- 2+ years of experience dealing with HEDIS/STAR procedures
- 1+ years of HEDIS/STAR experience or involvement with comparable regulative reporting
- ICD 9/10 and CPT coding experience
- Experience operating in a doctor, company, and/or medical workplace
- EMR and HEDIS understanding and experience
Physical and Mental Requirements:
- Ability to raise to 10 pounds
- Ability to press or pull heavy things consuming to 50 pounds of force
- Ability to represent prolonged amount of times
- Ability to utilize great motor abilities to run devices and/or equipment
- Ability to get and understand directions verbally and/or in composing
- Ability to utilize rational thinking for easy and intricate issue fixing
USMD part of OptumCare is a multi-specialty group of healthcare facility, centers and doctors. USMD serves the Dallas-Fort Worth city with more than 250 doctors and associate professionals, and offers health care services to clients in more than 20 various specializeds at its 2 medical facilities, 4 cancer treatment centers and almost 50 doctor centers, much of which are multi-specialty.
To secure the health and wellness of our labor force, clients and neighborhoods we serve, UnitedHealth Group and its affiliate business need all staff members to reveal COVID-19 vaccination status prior to starting work. In addition, some functions and areas need complete COVID-19 vaccination, consisting of boosters, as a vital task function. UnitedHealth Group sticks to all federal, state and regional COVID-19 vaccination guidelines in addition to all customer COVID-19 vaccination requirements and will get the needed details from prospects prior to work to guarantee compliance. Prospects need to have the ability to carry out all vital task functions with or without affordable lodging. Failure to satisfy the vaccination requirement might lead to rescission of a work deal or termination of work.
Careers with USMD. If you’re concept of a fantastic day at work includes putting fantastic originalities to work, we must talk. Throughout the higher Dallas location, we’ve constructed a progressing, incorporated healthcare design that brings medical care and expert service providers together to operate in brand-new and much better methods. A flourishing part of OptumCare and the UnitedHealth Group household of business, our multi – specialized group of medical facilities, centers and service providers includes more than 250 doctors and associate professionals. We supply healthcare services to clients in more than 20 various specializeds at our 2 medical facilities, 4 cancer treatment centers and almost 50 doctor centers. Join us and begin doing your life’s finest work.( sm)
WellMed was established in 1990 with a vision of being a physician-led business that might alter the face of health care shipment for elders. Through the WellMed Care Model, we concentrate on assisting our clients remain healthy by offering the care they require from medical professionals who appreciate them. We partner with several Medicare Advantage health insurance in Texas and Florida and eagerly anticipate continuing development.
Diversity produces a much healthier environment: OptumCare is an Equal Employment Opportunity/Affirmative Action companies and all certified candidates will get factor to consider for work without regard to race, color, faith, sex, age, nationwide origin, safeguarded experienced status, impairment status, sexual preference, gender identity or expression, marital status, hereditary details, or any other particular secured by law.
OptumCare is a drug-free office. Prospects are needed to pass a drug test prior to starting work
UnitedHealth Group
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