Practice Performance Specialist - Athens, GA

Position Description: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 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 Medical & Retirement membership.Primary Responsibilities:Assisting in the review of medical records to highlight Star opportunities for the medical staffPartner with your leadership team, the practice administrative or clinical staff to determine best strategies to support the practice and our membersAssist members in navigating their network of providers by assisting with follow-up and specialist appointments as neededAssist with program eligibility and appropriate referrals to remove barriers in care. This may include referrals to case management and/or social worker servicesInteraction with UHC members via telephone to assist and support an appropriate level of careThis may include making outbound calls to members and / or providers to assist in scheduling appointments, closing gaps in care or chart collection activitiesAnswer inbound calls from patients and / or providers regarding appointmentsCommunicate scheduling challenges or trends that may negatively impact quality outcomesActivities may include data collection, data entry, quality monitoring, HQPAF submission and chart collection activitiesTrack appointments and document information completely and accurately in all currently supported systems in a timely mannerDemonstrate sensitivity to issues and show proactive behavior in addressing customer needsProvide ongoing support and education to team members and assist in removing barriers in careOptimize customer satisfaction, positively impact the closing of gaps in care and productivityLocate medical screening results / documentation to ensure quality measures are followed in the closure of gapsWill not conduct any evaluation or interpretation of Clinical data and will be supervised by licensed and / or certified staffManage time effectively to ensure productivity goals are metAbility to work independently in virtual settingAbility to problem solve, use best professional judgment and apply critical thinking techniques to resolve issues as they ariseIdentify and seek out opportunities within one’s own work flow to improve call efficiencyAdhere to corporate requirements related to industry regulations / responsibilitiesMaintain confidentiality and adhere to HIPAA requirementsOther duties, as assigned

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 1+ years of working experience with ICD- 9 / 10 and CPT Codes 1+ years of working experience with Microsoft Office including Word, Excel (navigating, filtering, and analyzing reports), and Outlook 1+ years of working experience with and knowledge of HIPAA compliance requirements Strong data entry skills, with a typing speed of at least 45-50 WPM Access to reliable transportation that will enable you to travel to clients and / or patient sites within a designated area Ability to travel 25% - 75% of the time depending on business need (Must be able to travel within a 1-hour radius of Athens, GA.)Ability to work 8 hours a day, 40 hours a week between 7:00 am - 7:00 pmPreferred Qualifications: Experience working in a physician, provider, and / or medical office EMR and HEDIS knowledge and experience Medical Assistant CertificationCareers
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.

Keywords: Athens, GA, customer service, healthcare, field based, data entry