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Quality Coordinator

UnitedHealth Group

UnitedHealth Group

Quality Coordinator

Irving, TX
Full Time
Paid
  • Responsibilities

    POSITION DESCRIPTION

    The Quality Coordinator manages quality improvement initiatives under the supervision of team leadership using internal and external data extracted from multiple sources to create a plan to close quality gaps via contact with patients, providers, health care teams and clients. Interactive engagement with these stakeholders allows this role to assist the team in meeting all key performance indicators, plan based metrics and performance guarantees.

    PRIMARY RESPONSIBILITIES:

    Primary role (~75% of the time) is to call patients, and/or providers of care have current quality gaps in care. All conversations are accurately documented in the case management software platform

    • Patient calls focus on gathering information about visits that may have already occurred with external providers, education about gap closures, and assist in scheduling required appointments for gap closure
    • Provider calls focus on requesting records from an external provider that would close the quality measure (i.e. mammogram), as well as with any WellMed providers who can meet quality gaps within the PCP clinical setting (i.e. A1C testing)
    • 25% possible travel to local clinics for interactive engagement with HCP and Team around quality
    • Extract and work off internal and external daily reports from the CIN software and/or plan specific sites to extract and identify gaps in care
    • Prioritize patient-facing outreach upon the contractual quality gaps in care by region and plan type
    • Manage letter and postcard campaigns for gap closure in various markets
    • Create actionable quality initiative gap closure plans and timelines to address gaps in care by plan with management supervision
    • Demonstrate required goals of progression of quality gap closures by weekly reporting
    • Report on gap closure plan metrics including successes and opportunities for improvement
    • Professional oral and written communication with both internal and external audiences, which may include leadership, colleagues and patients
    • Record patients' medical history, vital statistics and additional information such as test results in electronic medical records as identified by outside medical records
    • Validate patient reported gap closure metrics by requesting records
    • Identify and share with leadership any team workflow process improvement opportunities to improve quality metrics
    • Attend required meetings, participate in team activities and professional development activities
    • Treat all customers, internal and external, in a courteous and cooperative manner
    • Serve as back up for the administrative coordinators when necessary
    • Collaborate with CIN Team members, regional Team members and physician Teams on gap closure initiatives

    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.

    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 380,000+ 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) WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth. 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.

  • Qualifications

    REQUIRED QUALIFICATIONS:

    • High school diploma or GED equivalent with relevant work experience in health care and quality required
    • Strong telephonic engagement and customer service skills
    • Excellent functional knowledge of Microsoft Office products, particularly Excel
    • Working knowledge of electronic medical records and practice management software
    • Understanding of healthcare industry primarily from a quality perspective
    • Ability to work in a fast paced and dynamic team environment Professional and clear communication
    • Ability to coordinate, prioritize and execute across multiples systems and platforms
    • Must be able to work in Irving office and potentially travel 25% of this role may include travel in a personal vehicle to local clinics. Since this role is primarily provider and patient facing, hours of coverage range from 9 AM to 7 PM local time to allow for optimal engagement opportunities

    PREFERRED QUALIFICATIONS:

    • Bachelor's degree with health care and/or quality experience
    • Medical Assistant certification
  • Industry
    Hospital and Health Care
  • Fun Fact
    UnitedHealth Group is working to create the health care system of tomorrow.
  • About Us

    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.