WellMed, part of the Optum family of businesses, is seeking a Clinical Administrative Coordinator to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live.
As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.
At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.
This position is responsible for effectively supporting the successful implementation and execution of all Clinical Quality processes. The Clinical Administrative 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.
This position is full-time, Monday - Friday. Employees are required to work during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. Employees are required to work 3 days onsite and 2 days from home.
We offer 4 weeks of on-the-job training. The hours during training will be 8:00am - 5:00pm, Monday - Friday. Training will be hybrid.
If you are within commutable distance to the office at 19500 Ih 10 W, San Antonio, TX, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.
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
- Performs all other related duties as assigned
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.
Required Qualifications:
- High School Diploma / GED
- Must be 18 years of age OR older
- 2+ years of administrative support experience
- Experience using Microsoft Office applications, including Microsoft Excel, Microsoft Word, and Microsoft Outlook
- Knowledge of medical terminology
- Ability to work on a Hybrid schedule and come to the office 3 times a week
- Ability to work Monday - Friday, during our normal business hours of 8:00am - 5:00pm, including the flexibility to work occasional overtime, based on the business need
Preferred Qualifications:
- Certified Medical Assistant training OR certification
- 3+ years of experience with data analysis / quality chart reviews
- 2+ years of experience in a physician’s clinic OR hospital
- 1+ years of HEDIS / STAR experience OR participation with similar quality regulatory reporting
- Experience working in a medical care setting as a receptionist OR medical assistant
- EMR and HEDIS knowledge and experience
- Bilingual fluency in English and Spanish
Telecommuting Requirements:
- Reside within a commutable distance to the office at 19500 Ih 10 W, San Antonio, TX
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
- Must be able to work independently, with some supervision and direction from manager
- Must possess and demonstrate excellent organizational skills, customer service skills, to include verbal and written communication
- Must maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all time
- Must maintain strict confidentiality at all time
- Must adhere to all department / organizational policies and procedures
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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