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HEDIS Quality Coordinator

Company: UnitedHealth Group
Location: Tyler
Posted on: January 15, 2022

Job Description:

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)
This position is responsible for 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 is a field based role that is located in the Dallas, TX market. *
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 scheduling 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 billing practices
Activities may include data collection, data entry, quality monitoring, health plan / WellMed form submission and chart collection activities
Assists with local IRR audits
Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS / Star measures
Support chart chase process by requesting records from provider's offices as needed
Maintains education / knowledge base of HEDIS / STARs
Performs all other related duties as assigned
The pace is fast and you'll need to be comfortable managing multiple priorities. You may be required to work in multiple locations, so scheduling flexibility is essential. You must also be able to respond calmly and effectively in emergency situations.

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 or GED
3+ years of healthcare experience to include experience in a managed care setting
3+ years of experience with data analysis / quality chart reviews
Ability to review data and provide recommendations for improvement
Experience using Microsoft office applications, including databases, word-processing, and excel spreadsheets
Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all -federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
Preferred Qualifications:
2+ years of college, in pursuance of a Bachelor's or Associate's degree
Licensed Vocational / Registered Nurse / Certified Professional Coder or Certified Medical Assistant
2+ years of experience working with HEDIS / STAR measures
1+ years of HEDIS / STAR experience or participation with similar regulatory reporting
ICD 9 / 10 and CPT coding experience
Experience working in a physician, provider, and / or medical office
EMR and HEDIS knowledge and experience

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
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 550,000+ 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)

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.

Job Keywords: HEDIS Quality Coordinator, DFW, HEDIS, quality, data mining, MA, Medical Assistant, Coding, LVN, managed care, chart review, CPC, - Dallas, Longview, -Tyler, -Mesquite, -Terrell, -Lufkin, TX, Texas

Keywords: UnitedHealth Group, Tyler , HEDIS Quality Coordinator, Other , Tyler, Texas

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