[Hiring] Clinical Practice Performance Coordinator @UnitedHealth Group

Role Description

The Clinical Practice Performance Coordinator serves as a key liaison between patients, emergency departments, and care teams, providing real-time support and coordination throughout the patient care journey. The position is responsible for member outreach, documentation, data entry, appointment scheduling, and ensuring compliance with CMS, NCQA, and Model of Care requirements while delivering exceptional customer service.

Schedule:

• A 40-hour work week, an 8 hour shift, Monday through Friday
• Shift one: 8:00 am to 4:30 pm CST
• Shift Two: 8:00 am to 4:30 pm EST
• Shift three: 5:00 pm to 1:30 am PST
• The schedule will be determined by supervisor upon hire.

Location:

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Documents all member interactions in a timely and concise manner that is compliant with documentation requirements for Model of Care, NCQA and Center for Medicare and Medicaid Services (CMS) regulations.
• Receives and responds to incoming ADT notifications utilizing the appropriate processes identified during training.
• Conducts in-bound and out-bound calls for program requirements including, but not limited to: engaging with identified emergency departments for patient support, monitoring patient ED journey remotely, scoping patients in for program needs, and warm handoffs to Optum APCs for collaborative care planning needs with the ED.
• Completes timely data entry of in-bound and/or out-bound call member contact information into software applications.
• Provides clerical and/or administrative support to clinical staff and managers for special projects and reporting needs.
• Provides excellent customer service by serving as a resource to all internal and external customers.
• Schedules appointments as needed in support of RNs completing real time care coordination efforts.
• Attends required meetings and participates in adhoc committees as needed.
• Identifies opportunities for process improvement in all aspects of member care.
• Must maintain strict confidentiality at all times.
• Must adhere to all department/organizational policies and procedures.
• Performs all other related duties as assigned.

Qualifications

• High School Diploma/GED
• Medical assistant certification
• 2+ years of administrative support experience
• Medical terminology knowledge base
• Ability to work schedule/shifts listed in the posting.
• Advanced level of computer experience with MS Word, Excel (create, edit, save documents) and Outlook (email and calendar management) and ability to use multiple web applications.
• Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI).
• Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Preferred Qualifications

• 2+ years of experience in an emergency room within a hospital.
• 2+ years of experience working in a medical care setting as a receptionist or medical assistant.
• Call Center experience.
• Utilizing a medical management system.

Soft Skills

• Ability to work independently and maintain good judgment and accountability.
• Proven ability to prioritize, plan, and handle multiple tasks/demands simultaneously.
• Proven ability to work independently, with some supervision and direction from manager.
• Proven ability to maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times.
• Proven ability to possess and demonstrate excellent organizational skills, customer service skills, to include verbal and written communication.

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays.
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account.
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage.
• 401(k) Savings Plan, Employee Stock Purchase Plan.
• Education Reimbursement.
• Employee Discounts.
• Employee Assistance Program.
• Employee Referral Bonus Program.
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.