HEDIS/STAR Quality Medical Records Coordinator

Optum

Plano (TX)

On-site

USD 28,000 - 50,000

Full time

6 days ago

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Benefits offered by this job

Comprehensive benefits

Incentives & recognition

401k plan

Job summary

WellMed, part of the Optum family, seeks a Clinical Quality Coordinator to coordinate HEDIS/STAR data gathering and drive quality improvements. You will review medical records, monitor data quality, and collaborate with clinical and administrative staff to close gaps in care.

The role requires CMA certification, 3+ years in managed care, and strong data analysis skills with proficiency in Microsoft Office and EHR systems.

Qualifications

High School diploma or GED required.
Certified Medical Assistant (CMA) with current BLS.
3+ years healthcare experience in a managed care setting.
3+ years data analysis and quality chart reviews.
2+ years as CMA.
Proficient in Microsoft Office (Word, Excel).
Knowledge of medical terminology.
TB screening and immunity requirements.

Responsibilities

Review medical records to identify Star/HEDIS opportunities for the medical staff.
Data collection, data entry, quality monitoring and chart submission.
Partner with leadership and staff to identify trends and strategies to improve care.
Communicate scheduling challenges affecting quality outcomes.
Track barriers to improve outcomes, such as access and referrals.
Navigate multiple documentation systems for HEDIS/STAR measures.
Support chart chase by requesting records from providers.
Maintain knowledge of HEDIS/STAR measures and requirements.
Perform other related duties as assigned.