Experienced Field Based Clinical Practice Performance Coordinator - Healthcare Quality Improvement and Customer Service Expert

Introduction to Optum and Our Mission

Optum, a global organization, is dedicated to delivering care aided by technology to help millions of people live healthier lives. Our team's work directly improves health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. We pride ourselves on a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. By joining us, you will be part of a journey to advance health equity on a global scale, making a real impact on the communities we serve.

Job Overview

We are seeking an experienced and skilled Field Based Clinical Practice Performance Coordinator to join our team in Greenville, NC. This full-time position (40 hours/week) offers a competitive salary and the opportunity to work with a talented team of professionals who share your passion for healthcare quality improvement and customer service. As a Field Based Clinical Practice Performance Coordinator, you will play a critical role in reviewing medical records, identifying opportunities for quality improvement, and providing exceptional customer service to our members and providers.

Key Responsibilities

• Assist in the review of medical records to highlight Star opportunities for the medical staff, ensuring that quality measures are followed and gaps in care are addressed.
• Collect and analyze data, enter information into our systems, and monitor quality metrics to identify areas for improvement.
• Locate medical screening results and documentation to ensure that quality measures are followed and gaps in care are closed, without conducting any evaluation or interpretation of clinical data.
• Track appointments, document information accurately and completely in our systems, and optimize customer satisfaction and productivity.
• Partner with your leadership team, practice administrative or clinical staff to determine the best strategies to support the practice and our members, ensuring that recommended preventative health screenings are completed and HEDIS gaps in care are addressed.
• Interact with UHC members via telephone to assist and support an appropriate level of care, making outbound calls to members and/or providers to assist in scheduling appointments, closing gaps in care, or chart collection activities.
• Answer inbound calls from members and/or providers regarding appointments, communicate scheduling challenges or trends that may negatively impact quality outcomes, and demonstrate sensitivity to issues and proactive behavior in addressing customer needs.
• Provide ongoing support and education to team members, assist in removing barriers in care, and manage time effectively to ensure productivity goals are met.
• Work independently in a virtual setting, using best professional judgment and applying critical thinking techniques to resolve issues as they arise, and identify opportunities to improve call efficiency.
• Adhere to corporate requirements related to industry regulations and responsibilities, maintain confidentiality, and adhere to HIPAA requirements.
• Analyze data from multiple system platforms to identify open quality opportunities to address on a member or provider level, and coordinate appointments for specialist appointments, late to refill medication outreach, and scheduling members for local market clinic events.
• Participate in department campaigns to improve overall quality improvements within measure star ratings or contracts, and support field-based activities to target providers.

Essential Qualifications

• High School Diploma / GED
• 18 years or older
• 2 years of telephonic customer service experience
• 1 year of healthcare background with medical terminology and clinical issues familiarity
• 1 year of working experience with ICD-9/10 and CPT Codes
• 1 year of working experience with knowledge of HIPAA compliance requirements
• 1 year of working experience with Microsoft Tools: Microsoft Word (create and edit correspondence) and Microsoft Outlook (email and calendar management)
• Experience with navigating, filtering, and analyzing reports in Microsoft Excel
• Ability to travel up to 75% of the time within the Greenville, NC area
• Reside within commutable distance of Greenville, NC
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company-sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00 am-5:00 pm EST, Monday to Friday

Preferred Qualifications

• 1 year of experience as a pharmacy technician
• Experience working in a physician, provider, and/or medical office
• Medical Assistant or LPN certification
• EMR and HEDIS knowledge and experience
• Pharmacy tech license

Soft Skills

• Strong data entry skills, with a typing speed of at least 45-50 WPM
• Demonstrated ability to identify with a consumer to understand and align with their needs and realities
• Demonstrated ability to perform effective active listening skills to empathize with the customer and develop trust and respect
• Demonstrated ability to take responsibility and be internally driven to accomplish goals and recognize what needs to be done to achieve goals
• Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
• Good attendance record

Career Growth Opportunities and Learning Benefits

At UnitedHealth Group, we are committed to helping our employees grow and develop in their careers. We offer a range of training and development programs, including our comprehensive 4-8 weeks of paid training for this role. Our training programs are designed to help you build the skills and knowledge you need to succeed in your role and advance in your career. We also offer opportunities for professional growth and advancement, as well as a range of benefits and perks to support your well-being and success.

Work Environment and Company Culture

Our company culture is guided by our mission to help people live healthier lives and make the health system work better for everyone. We believe in creating a diverse and inclusive work environment that values and respects all employees, regardless of their background or circumstances. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes. Our workplace is dynamic and fast-paced, with a focus on collaboration, innovation, and customer satisfaction.

Compensation, Perks, and Benefits

We offer a competitive salary and a range of benefits and perks to support your well-being and success. Our benefits package includes comprehensive health insurance, retirement savings, and paid time off, as well as a range of other perks and discounts. We also offer opportunities for professional growth and advancement, as well as a range of training and development programs to help you build the skills and knowledge you need to succeed in your role.

Conclusion

If you are a motivated and skilled healthcare professional looking for a new challenge, we encourage you to apply for this exciting opportunity. As a Field Based Clinical Practice Performance Coordinator, you will play a critical role in improving health outcomes and providing exceptional customer service to our members and providers. Don't miss out on this opportunity to join our team and make a real difference in the lives of others. Apply today!

Don't worry if you don't meet every single requirement. We value a great attitude and a willingness to learn above all. Submit your application today and take the first step towards a rewarding and challenging career with UnitedHealth Group.