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UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Senior Clinical Practice Performance Coordinator
Location
United States
Posted
8 days ago
Salary
$24 - $43 / hour
Seniority
Senior
No structured requirement data.
Job Description
Senior Clinical Practice Performance Coordinator
UnitedHealth Group
Role Description This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. This role will be responsible for ongoing management of quality & Risk Adjustment medical record collection. The Senior Clinical Practice Performance Coordinator will perform record retrieval with the goal to increase HEDIS®, CMS STARs, and state-specific measure performance scores by planning, performing, coordinating, and monitoring medical record collection activities to meet or exceed quality and Risk standards, contractual requirements, and pay for performance incentives. Individual must be highly organized, with demonstrated professional maturity and emotional resilience. Day-to-day work mainly involves retrieval via remote EMR access to increase collection of member compliant information resulting in improved HEDIS® or other quality or Risk program rates. - Building and maintaining provider group relationships. - Understanding and detailed documentation of provider group relationships and medical record collection requirements. - Mining and reviewing data for project quality assurance. - Utilization of multiple claims systems, medical record collection tracking tools, electronic medical record systems, secure FTP, external lab portals, and immunization registries. This position is full time, Monday - Friday. Employees are required to have flexibility to work during our normal business hours of 8:00 am - 5:00 pm. 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. Qualifications - High School Diploma / GED OR 2+ years of equivalent experience. - Must be 18 years of age OR older. - 2+ years of healthcare industry OR managed care experience. - 1+ years of direct HEDIS® and/or Risk Adjustment and/or medical record review experience. - Experience with Microsoft Word, Excel, Outlook, and PowerPoint. - Ability to travel up to 10% of the time domestically. - Ability to work full time, Monday - Friday. Requirements - Overall HEDIS® and other quality and Risk Adjustment program knowledge. - Develops an understanding of HEDIS® and Risk Adjustment including project timelines. - Completion of all required measure-level training. - Understanding of Risk adjustment and additional quality programs. - Basic working understanding of billing and claims coding. - Ability to meet timelines associated with project tasks. - Builds trust and forms effective relationships with providers. - Research and outreach to understand provider group roll-ups. - Consistently maintain an accurate, detailed repository of provider relationships. - Attend and participate in team meetings. - Develop an in-depth understanding of multiple collection methods. - Coordinates and performs medical record collection. - Creates custom request lists based on identified provider group requirements. - Ability to sort and format data via Excel. - In-depth knowledge of and complete adherence to HIPAA guidelines. - Effectively and independently operate equipment. - Utilize multiple systems including claims systems and medical record collection tracking tools. - Strong Microsoft Office knowledge and skills. - Knowledge of Adobe Acrobat. - Ability to navigate multiple electronic medical record systems. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase and 401k contribution. - Hourly pay for this role will range from $24 - $43 per hour based on full-time employment. Telecommuting Requirements - Ability to keep all company sensitive documents secure. - Required to have a dedicated work area established that is separated from other living areas. - Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection. Soft Skills - Strong, professional, and effective interpersonal and communication skills. - Energy, motivation, and commitment to drive results. - Diplomatic with strong negotiation and conflict resolution skills. - Demonstrated ability to meet commitments and build consensus. - Demonstrates adaptability in a highly changing environment. - Presentation skills with the ability to present to various stakeholders. - Exhibits creative problem-solving skills. - Ability to effectively manage time and large workloads. - Ability to work independently with minimal intervention. - Effective organizational skills.
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