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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Business Operations

Country:

United States

Postal Code:

90623

Approximate Salary:

Not Specified

Position Type:

Full Time

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CDQI Quality Improvement Coordinator - La Palma, CA

UHG - LA PALMA, California

Posted: 09/7/2018

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)


AppleCare Medical Management Group.  The multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.

  Responsible for Clinical Performance Improvement related activities, including but not limited to, P4P & HEDIS improvement, Quality Improvement Activities and Star Rating improvement   Primary Responsibilities:
  • Data entry
  • Manual gap closure in Care Manager
  • Download weekly reports from OHR
  • Download weekly reports from Care Manager
  • Download Reports from health plan websites/ftps
  • Update health plan report log
  • Prepare weekly STARS summary reports
  • Prepare weekly P4P summary reports
  • Create and send and log quality program faxes to provider offices
  • Maintain update quality program repository
  • Back-up for printing, sorting and batching incoming faxes
  • Research bad phone numbers for members in quality programs
  • Prepare and send member mailings for Quality programs
  • Generate referrals for quality programs and send to members
  • Print gaps in care reports as requested by HCC and/or Network Mgt
  • Testing and validation of quality systems and reports
  • QA projects from mailing vendor
  • Other duties as assigned

Required Qualifications:

  • 1+ year of experience in a hospital, medical group, health plan or IPA setting
  • Intermediate skills with Excel, Outlook and Word
  • Valid California Driver’s License and proof of automobile insurance
  • Able to travel locally 10% of the time using own transportation

Preferred Qualifications:

  • High school education or equivalent experience
  • Care Manager system experience
  • Working with STARS and P4P reports
  • Working knowledge of HEDIS
  • Testing and validation of quality systems and reports experience
  • Work is frequently completed without established procedures
  • Works independently
  • May act as a resource for others
  • Applies knowledge/skills to a range of moderately complex activities
  • Demonstrates great depth of knowledge/skills in own function
  • Solves moderately complex problems on own
  • Ability to multitask
  • Works with team to solve complex problems
  • Plans, prioritizes, organizes and completes work to meet established objectives
  • Dependable, punctual and willing to adapt to changing itineraries
  • Ability to read quickly with excellent comprehension and retention

 

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company 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.

 

Job keywords: Managed care, quality improvement, data entry, analyst, Medicare, provider, HEDIS, CAHPS, HOS, NCQA, IHA-PAP, STAR, La Palma, CA, California, Applecare



 

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