HEDIS & STAR Quality Coordinator

Texas Health Institute; Plano, Northern (TX, KY); Hybrid; USD 28,000 - 50,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase plan

401k contribution

Job summary

WellMed, part of the Optum family, is seeking a Clinical Quality Coordinator to manage HEDIS/STAR data gathering and medical record reviews. You will ensure data quality, identify improvement opportunities, and support chart collection across practices.

Responsibilities include data collection, trend analysis, and coordinating with staff to close care gaps. Experience in managed care, EHR, and HEDIS/STAR is preferred; a strong clinical background is required.

Qualifications

• High School diploma or GED.
• Sustained Medical Assistant certification.
• Current BLS certification.
• 3+ years of healthcare experience in a managed care setting.
• 3+ years of data analysis/quality chart reviews with ability to recommend improvements.
• 2+ years as a Certified Medical Assistant.
• Proficient in Microsoft Office (databases, Word, Excel).
• Knowledge of medical terminology.
• Proven ability to mentor others.
• Proven expertise with electronic health records (EHR).
• TB screening and immunization requirements documented or verified.

Responsibilities

• Assist in reviewing medical records to identify Star/HEDIS opportunities.
• Review records for data collection, data entry, and quality monitoring.
• Partner with leadership to identify trends and strategies for practice improvement.
• Communicate scheduling challenges affecting quality outcomes.
• Track barriers to improve outcomes (access, referrals, billing).
• Support chart chase and record submission activities as needed.
• Navigate multiple documentation systems to gather supporting HEDIS/STAR data.
• Maintain knowledge base of HEDIS/STAR measures.

Skills

Healthcare experience

Data analysis

Mentoring

MS Office & Excel

Medical terminology

EHR proficiency

Team collaboration

Education

High School diploma or GED

Sustained Medical Assistant certification

Current BLS certification

Licensed Vocational/Registered Nurse or Certified Professional Coder

2+ years college experience

Job description

WellMed, part of the Optum family, is seeking a Clinical Quality Coordinator to manage HEDIS/STAR data gathering and medical record reviews. You will ensure data quality, identify improvement opportunities, and support chart collection across practices.

Responsibilities include data collection, trend analysis, and coordinating with staff to close care gaps. Experience in managed care, EHR, and HEDIS/STAR is preferred; a strong clinical background is required.