Practice Performance Specialist

  • United Health Group
  • Tallahassee, FL
  • Dec 16, 2022
Full time Health Care Medical

Job Description

  • 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 ensuring that recommended preventative health screenings are completed and HEDIS gaps in care are addressed
  • 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 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
  • 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
  • Manage time effectively to ensure productivity goals are met
  • Ability to work independently in virtual setting. Ability to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they arise
  • Identify and seek out opportunities within one’s own work flow to improve call efficiency
  • Adhere to corporate requirements related to industry regulations/responsibilities
  • 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

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