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UnitedHealth Group Clinical Practice Performance Coordinator - Remote within 50 miles of Horry County, SC in Myrtle Beach, South Carolina

Combine two of the fastest - growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making Healthcare data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life’s best work.

Employees in this position will work on - site or virtually as an extension of the local quality and provider teams by aligning to geographical regions, medical centers and / or physician practices that manage a high volume of UHC Medicare and Retirement membership.

If you are located in the Myrtle Beach, SC area, you will have the flexibility to telecommute* as you take on some tough challenges.

We offer 1-3 weeks of paid training. The hours during training will be 8:00am to 5:00pm, Monday - Friday.

Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

  • Assist in the review of medical records to highlight Star opportunities for the medical staff

  • Activities include data collection, data entry, quality monitoring, upload of images, and chart collection activities

  • Locate medical screening results / documentation to ensure quality measures are followed in the closure of gaps. Will not conduct any evaluation or interpretation of Clinical data

  • Track appointments and document information completely and accurately in all currently supported systems in a timely manner

  • Optimize customer satisfaction, positively impact the closing of gaps in care and productivity

  • Partner with your leadership team, the practice administrative or clinical staff to determine the best strategies to support the practice and our members

  • Interaction with UHC members via telephone to assist and support an appropriate level of care. This may include making outbound calls to members and / or providers to assist in scheduling appointments, closing gaps in care, medication refill reminder and education or chart collection activities

  • Answer inbound calls from patients and / or providers regarding appointments

  • Communicate scheduling challenges or trends that may negatively impact quality outcomes

  • Demonstrate sensitivity to issues and show proactive behavior in addressing customer needs

  • Provide ongoing support and education to team members and assist in removing barriers in care

  • Maintain confidentiality and adhere to HIPAA requirements

  • Data analysis required for multiple system platforms to identify open quality opportunities to address on a member or provider level

  • Appointment coordination for specialist appointments, late to refill medication outreach and scheduling members for local market clinic events

  • Participate within department campaigns to improve overall quality improvements within measure star ratings or contracts

  • Field based activities require the abilities to support appropriate targeted providers

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 (or higher)

  • 2+ years of telephonic customer service experience

  • 1+ years of a healthcare background with medical terminology, familiarity of clinical issues and working with members/patients

  • 1+ years of working experience with Microsoft Tools: Microsoft Word (creating memos, writing), Microsoft Outlook (setting calendar appointments, email) and Microsoft Excel (creating spreadsheets, filtering, navigating reports)

  • 1+ years of working experience with and knowledge of HIPAA compliance requirements

  • Ability to work Monday – Friday, 8 am - 5 pm

  • Have a dedicated work area established that is separated from other living areas and provides information privacy when working remote

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • 1+ years of working experience with ICD - 9 / 10 and CPT Codes

  • LPN or Pharmacy Technician experience

  • Experience working in a physician, provider, and / or medical office

  • Knowledge and experience with EMR and HEDIS

  • Experience with medication adherence coaching

  • Knowledge of Horry, Marion and Georgetown Counties

  • Strong data entry skills

Soft Skills:

  • Ability to keep all company sensitive documents secure (if applicable)

  • Manage time and multiple priorities effectively to ensure productivity goals are met\

  • Ability to work independently in virtual setting

  • Identify and seek out opportunities within one’s own work-flow to improve call efficiency

  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities

  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect

  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s)

  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer

  • Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise

  • Adhere to corporate requirements related to industry regulations / responsibilities

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Careers with OptumInsight. Information and technology have amazing power to transform the Healthcare industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.

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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