Quality Medical Assistant MA WellMed Plano Texas

Explore opportunities with Well Med, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring.

Connecting. Growing together.

This position is responsible for the coordination of HEDIS and STARs data gathering process. This evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, identifying trends, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records.

The Clinical Quality Coordinator will be duty to provide a standard of care that meets or exceeds that of a reasonably competent and knowledgeable Medical Assistant.

Primary Responsibilities:

• Assisting in the review of medical records to highlight Star/HEDIS opportunities for the medical staff
  • Review medical records for data collection, data entry, and quality monitoring including health plan/Well Med form submission and chart collection activities that close gaps in care
  • Partner with the leadership team, the practice administrative or clinical staff to identify trends observed and potential strategies to support the practice
• Communicate scheduling challenges or trends that may negatively impact quality outcomes
• Track and trend barriers/challenges that exist at their assigned groups so that better outcomes can be achieved including access to appointments, lack of follow up on referrals, or inconsistent billing practices
• Activities may include data collection, data entry, quality monitoring, health plan/Well Med form submission and chart collection activities
• Assists with local IRR audits
• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures
• Support chart chase process by requesting records from provider's offices as needed
• Maintains education/knowledge base of HEDIS/STARs
• Performs all other related duties as assigned

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 or GED
• Sustained Medical Assistant certification
• Current BLS certification
  • 3+ years of healthcare experience to include experience in a managed care setting
  • 3+ years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement
  • 2+ years as a Certified Medical Assistant
• Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets
• Knowledge of medical terminology
• Proven ability to mentor others
• Proven expert in computer literacy in electronic health record
• This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease

Preferred Qualifications:

• Licensed Vocational/Registered Nurse, or Certified Professional Coder
• 2+ years of college, in pursuance of a Bachelor's or Associate's degree
• 2+ years of experience working with HEDIS/STAR measures. ICD 9/10 and CPT coding experience
• 1+ years of HEDIS/STAR experience or participation with similar regulatory reporting
• Experience working in…