Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve YOUR LIFE'S BEST WORK.(SM)

WellMed provides concierge - level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health. WellMed's proactive approach focuses on prevention and the complete coordination of care for patients. WellMed is now part of the Optum division under the greater UnitedHealth Group umbrella. This position is responsible for effectively supporting the successful implementation and execution of all Clinical Quality processes. The Quality Coordinator will provide support to 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. This position will serve as a liaison with internal/external customers/departments to ensure optimal customer service.

PO SITION IS BASED IN SAN ANTONIO, TX 12447 NETWORK BLVD. MONDAY-FRIDAY: 8AM-5PM

PRIMARY 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 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 coding practices.
• Activities may include data collection, data entry, quality monitoring, health plan / WellMed form submission and chart collection activities.
• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures.
• Support quality initiatives by requesting medical records from provider's offices as needed.
• Receives and responds to incoming Clinical Quality inquiries from all communication venues: e.g. phone and fax queue, TruCare, or department e - mail box.
• Conducts in - bound and out - bound calls for quality requirements including, but not limited to: patient scheduling, medical records requests, contact verification.
• Documents timely patient and clinic interactions of in - bound and/or out-bound calls into software applications
• Provides clerical and / or administrative support to quality staff and managers for special projects and reporting needs.
• Provides excellent customer service by serving as a resource to all internal and external customers.
• Maintains education / knowledge base of HEDIS / STARs.

REQUIRED QUALIFICATIONS:

• High School Diploma or GED
• 2 + years of administrative support experience
• Experienced using Microsoft Office applications, including Excel, Word, and Outlook
• Possesses medical terminology knowledge base

PREFERRED QUALIFICATIONS:

• Certified Medical Assistant training or certification
• 2 + more years of experience in a physician's clinic or hospital
• Additional years of experience working in a medical care setting as a receptionist or medical assistant
• Bilingual language proficiency (English / Spanish)
• 3 + more years of experience with data analysis / quality chart reviews
• 1 + more years of HEDIS / STAR experience or participation with similar quality regulatory reporting
• EMR and HEDIS knowledge and experience

CAREERS WITH WELLMED. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do YOUR LIFE'S BEST WORK.(SM)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, we’re doing a lot of good for more than 142 million people worldwide.