Field Based Clinical Quality Coordinator - Albuquerque, NM

Optum - Algodones, NM

Full-time - Entry Level

Algodones, NM

Insurance Carriers and Related Activities

About the position

The Field Based Clinical Quality Coordinator at Optum is responsible for participating in quality improvement initiatives within their assigned territory. This role involves collaborating with various teams to collect medical records that support HEDIS and Stars activities, ultimately aiming to improve health outcomes and advance health equity. The position requires flexibility in working hours and may involve local travel to fulfill responsibilities effectively.

Responsibilities

• Conduct medical record reviews and data collection to support quality improvement initiatives.
• Collaborate with Clinical Quality, Network Management, and Risk Education teams to identify trends and strategies for assigned practices.
• Track and analyze barriers and challenges within the assigned territory to enhance health outcomes.
• Navigate multiple documentation systems (EMRs) to obtain medical records for quality improvement.
• Maintain knowledge of HEDIS/STARs and perform related duties as assigned.

Requirements

• High School diploma / GED
• Must be 18 years of age or older
• 2+ years of healthcare experience in provider and patient-facing interactions
• 1+ years of quality chart review and abstraction experience
• Proficiency in Microsoft Office applications (Outlook, Word, PowerPoint, Excel)
• Valid NM Driver's License and ability to travel up to 75% locally
• Ability to work any of the 8-hour shift schedules during normal business hours.

Nice-to-haves

• 1+ years of experience in HEDIS/STARS
• ICD 10 and CPT coding experience
• Experience working in a physician, provider, and/or medical office
• Knowledge and experience with EMR and HEDIS.

Benefits

• Comprehensive benefits package
• Career development opportunities
• On-the-job training
• Flexible work hours
• Recognition for performance