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Posted : Sunday, September 01, 2024 06:03 PM
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.
The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best.
Come make an impact on the communities we serve as we help advance health equity on a global scale.
Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.
SM This position will work directly with our Quality and Risk Adjustment market-based teams and providers with both our employed and contracted providers in the respective market position are assigned.
The PSU Logistical Support Admin is responsible for collecting data and capturing the Quality measures.
Delivers quality customer service and maintains established quality control standards.
This position will be held accountable for the following metrics % of appointments schedule, # of Gaps Closed, Post Audit/Reporting accuracy/audits complete, overall 5 Star rating for HMO products, and to achieve other assigned POD goals/metric objectives as assigned.
Location: 5004 122nd Street #200, Lubbock, TX 79424 Schedule: Monday to Friday 8:00am to 5:00pm CST Primary Responsibilities: Greets patients as they arrive and manages wait time Complete check-in and check-out tasks to include insurance verification, complete pre-authorizations and/or precertification of procedures, and copy required documents Processes walk-in patients and visitors Answers phones and schedules appointments Answer telephone calls, re-direct calls as appropriate, assist callers with questions or concerns, and take messages as needed Manages medical records (maintains, files/scans, prepares for schedule) Ensures all correspondence is scanned and/or filed, processes requests for medical records release and maintains appropriate logs, etc.
Establish and maintain effective working relationships with patients, employees, and the public Auditing support for PSU and/or data miners (validation of PRP open/closed gaps) Use ePRG to pull various reports including but not limited to PML, Pink Box, Patient Summary detail, etc.
Calculating and Submitting expenses and mileage for established POD Quality assurance review of submitted forms for PSU Troubleshooting for missing elements (i.
e.
may include calling radiology providers for copies of mammogram reports) Equipment supply ordering and registration/check out to various employees Assist PSR as necessary with outbound calls Cover for Field PSU Data Mining events when necessary Preparation of visit checklist and packets for MA/NP visits (including preparing packet of SDS, FOC, Attestation, and Patient Summary Detail log) Responsible for keeping the overall calendar of all PSU/QRA activities/interventions including any PSU screening events Ensure weekly reporting of activities of all PSU/Data mining staff is accurate and timely Responsible for ensuring all Resource Requests are sourced and staffed appropriately Coordinate with mobile screening vendor(s) for completion of FOC Create any member mailings or customized calling scripts that are necessary to support QRA PSU efforts Conduct post audits and ensure all gap measure were capture by corporate team (e.
g.
, no longer pink in pink box) Responsible for end-to-end process flow and accountable for achieving targets established for their PODS.
Ensure direct manager has accurate knowledge of progress, risks, and barriers proactively Identify training opportunities for staff based on post audits and report findings to direct manager 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/GED (or higher) 2+ years of experience working with Microsoft Office – Excel, word, etc.
1+ years of related work experience including data entry, auditing and/or medical front office experience 1+ years of experience with effective communication and customer service skills both in person and via phone Must be able to work on site and when business needs require may work 10% or less remotely Must have the access for high-speed internet when business may require working remotely Preferred Qualifications: Working knowledge of medical office procedures and medical terminology ICD 10 and CPT coding experience Bilingual (English/Spanish) 1+ years of Managed Care experience Access to reliable transportation and the ability to travel frequently within assigned market Soft Skills: Ability to accurately sort and file materials by alphabetic or numeric systems Be flexible and adaptable to change At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes.
We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.
UnitedHealth Group is a drug - free workplace.
Candidates are required to pass a drug test before beginning employment.
#RPO #Red
The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best.
Come make an impact on the communities we serve as we help advance health equity on a global scale.
Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.
SM This position will work directly with our Quality and Risk Adjustment market-based teams and providers with both our employed and contracted providers in the respective market position are assigned.
The PSU Logistical Support Admin is responsible for collecting data and capturing the Quality measures.
Delivers quality customer service and maintains established quality control standards.
This position will be held accountable for the following metrics % of appointments schedule, # of Gaps Closed, Post Audit/Reporting accuracy/audits complete, overall 5 Star rating for HMO products, and to achieve other assigned POD goals/metric objectives as assigned.
Location: 5004 122nd Street #200, Lubbock, TX 79424 Schedule: Monday to Friday 8:00am to 5:00pm CST Primary Responsibilities: Greets patients as they arrive and manages wait time Complete check-in and check-out tasks to include insurance verification, complete pre-authorizations and/or precertification of procedures, and copy required documents Processes walk-in patients and visitors Answers phones and schedules appointments Answer telephone calls, re-direct calls as appropriate, assist callers with questions or concerns, and take messages as needed Manages medical records (maintains, files/scans, prepares for schedule) Ensures all correspondence is scanned and/or filed, processes requests for medical records release and maintains appropriate logs, etc.
Establish and maintain effective working relationships with patients, employees, and the public Auditing support for PSU and/or data miners (validation of PRP open/closed gaps) Use ePRG to pull various reports including but not limited to PML, Pink Box, Patient Summary detail, etc.
Calculating and Submitting expenses and mileage for established POD Quality assurance review of submitted forms for PSU Troubleshooting for missing elements (i.
e.
may include calling radiology providers for copies of mammogram reports) Equipment supply ordering and registration/check out to various employees Assist PSR as necessary with outbound calls Cover for Field PSU Data Mining events when necessary Preparation of visit checklist and packets for MA/NP visits (including preparing packet of SDS, FOC, Attestation, and Patient Summary Detail log) Responsible for keeping the overall calendar of all PSU/QRA activities/interventions including any PSU screening events Ensure weekly reporting of activities of all PSU/Data mining staff is accurate and timely Responsible for ensuring all Resource Requests are sourced and staffed appropriately Coordinate with mobile screening vendor(s) for completion of FOC Create any member mailings or customized calling scripts that are necessary to support QRA PSU efforts Conduct post audits and ensure all gap measure were capture by corporate team (e.
g.
, no longer pink in pink box) Responsible for end-to-end process flow and accountable for achieving targets established for their PODS.
Ensure direct manager has accurate knowledge of progress, risks, and barriers proactively Identify training opportunities for staff based on post audits and report findings to direct manager 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/GED (or higher) 2+ years of experience working with Microsoft Office – Excel, word, etc.
1+ years of related work experience including data entry, auditing and/or medical front office experience 1+ years of experience with effective communication and customer service skills both in person and via phone Must be able to work on site and when business needs require may work 10% or less remotely Must have the access for high-speed internet when business may require working remotely Preferred Qualifications: Working knowledge of medical office procedures and medical terminology ICD 10 and CPT coding experience Bilingual (English/Spanish) 1+ years of Managed Care experience Access to reliable transportation and the ability to travel frequently within assigned market Soft Skills: Ability to accurately sort and file materials by alphabetic or numeric systems Be flexible and adaptable to change At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes.
We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.
UnitedHealth Group is a drug - free workplace.
Candidates are required to pass a drug test before beginning employment.
#RPO #Red
• Phone : NA
• Location : Lubbock, TX
• Post ID: 9077122734
