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The Logistical Support Admin will work directly with the Quality and Risk Adjustment market based teams and providers with both the employed and contracted providers in the respective market position are assigned. The PSU (Patient Support Unit) 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 percentage of appointments schedule, number of gaps closed, post audit/reporting accuracy/audits complete, overall 5 star rating for HMO products, and to achieve other assigned market group (POD) goals/metric objectives as assigned.
- Responsible for end to end process flow and accountable for achieving targets established for their market groups (PODS).
- Preparation of visit checklist and event packets for LPN/NP visits (including preparing EMR system to reflect open gaps, event type, pulling attestations from ePRG, etc)
- Conduct post audits and ensure all gap measure were capture by corporate team (e.g. no longer pink in pink box)
- Ensure weekly reporting of activities of all PSU/Data mining staff is accurate and timely
- Responsible for keeping the overall calendar of all PSU/QRA activities/interventions including any PSU events
- Ensure direct manager has accurate knowledge of progress, risks, and barriers proactively.
- Coordinate focus groups to communicate progress, risks and/or barriers back to the market
- Identify training opportunities for staff based on post audits and report findings to direct manager.
- Responsible for ensuring all Resource Requests are sourced, staffed and tracked appropriately
- Auditing support for the department (PSU) and/or data miners (validation of PRP open/closed gaps)
- Use internal systems (ePRG) to pull various reports including but not limited to PML, Pink Box, Patient Summary detail, etc.
- Quality assurance review of submitted forms for PSU
- Effective communication and customer service skills required
- Ability to adhere to daily schedules and duties
- Excellent listening skills
- Ability to travel frequently within assigned market
- Ability to think critically
- Excellent Customer Service voice and demeanor
- Ability to exercise sound judgment in the handling of complex inquiries per protocol
- Ability to effectively de-escalate and resolve issues
- Working knowledge of medical office procedures and medical terminology
- Ability to work effectively in a fast paced healthcare driven environment
- Ability to accurately sort and file materials by alphabetic or numeric systems
- Current Driver’s License and reliable transportation with ability to travel to provider offices.
- 2+ years of healthcare related experience including data entry in a medical office
- Proficiency with Microsoft Office – Excel, word, etc.
- High school diploma or GED
Vacancy Type: Full Time
Job Location: Tampa, FL, US
Application Deadline: N/A