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Optum Quality Care Coordinator in Colorado Springs, Colorado

HIPAA SECURITY LEVEL: High access to systems/patient information

Summary: Conduct patient outreach for management and coordination of care for chronic medical conditions and preventative health screenings. Provide education to patients about their medical conditions and directions/interventions as prescribed by their providers. Review medical records and research and outreach across healthcare teams for documentation to provide complete medical record pictures for members. Assist with other quality campaigns as needed.

Education, Skills and Abilities:

  • Licensed Practical Nurse (LPN) or experienced Medical Assistant preferred

  • Strong Electronic Health Records (EHR) skills along with Microsoft Word and Microsoft Excel proficiency

  • Experience in Healthcare Quality and/or working with IPA/Affiliate providers preferred

  • Knowledge of patient education principles

  • Strong communication skills

  • Skill in establishing and maintaining effective working relationships with patients, providers, medical staff, and health plan staff

  • Ability to work independently with minimum supervision

  • Excellent customer service and telephone skills

  • Independent and confident decision making ability

  • Able to function as an individual contributor as well as a team player

  • Other duties as needed

Essential Responsibilities:

  • Conduct telephonic patient outreach to patients with chronic conditions and/or preventative care needs

  • Conduct telephonic outreach to remind patients to schedule annual wellness visits and/or other chronic care appointments.

  • Assist patients with hospital follow-up appointment needs

  • Provide patient education and guidance on disease management and care coordination

  • Review medical records and other healthcare data sources, and outreach to facilities and/or providers to obtain patient records, results, and/or reports for quality gap closure.

  • Assist Quality Manager and/or Quality Supervisor in serving as a liaison between providers, office staff, patients, and insurance plans

  • Communicate with physicians regarding patient care and needs as well as best practice tips on attaining quality care metric goals

  • Utilize knowledge of resources available in the health care system to assist the physician and patient effectively

  • Assist patient with any healthcare needs as appropriate and able, to ensure a high-quality patient experience

  • Perform other duties as required or requested by the CMO or Quality Director

Supervisory Duties:

  • None

Work Environment/Schedule:

  • Office and clinic environment, some remote option. Full time