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This position supports the UnitedHealthcare’s Vision Clinical Quality Team and NCQA HEDIS Dilated retinal eye exam requirements for our health plans. The Vision Quality Coordinator/Specialist would be responsible for coordinating and facilitating all HEDIS Measure Eye Exam for Patients with Diabetes (EED) related initiatives and serving as a liaison to support all health management programs and quality improvement activities as directed by the VP of Clinical Programs and Vision Clinical Quality Team. This includes the oversight of all department HEDIS reports and analyses, coordination of HEDIS outreach efforts and facilitation of HEDIS preparation and data collection for annual chart review efforts. The candidate will need to understand the importance of educating members, providers and health plans on the importance of regular retinal eye exams/screenings and the difference between routine and dilated or retinal eye exams. The candidate has a strong ophthalmic assistant or technician background to lend clinical knowledge and experience towards the creation of clinical programs for our health plan clients.
The Vision Quality Coordinator thrives in an environment of creating brand new clinical programs around utilization, formulary, HEDIS, provider excellence, etc. It is preferred that the candidate have some familiarity with HEDIS and regulatory/compliance constraints in the Medicaid/Medicare space, however this can be learned on the job. Greater than 3-5 years of patient eye care and vision billing/coding experience is a plus.
You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Coordinate and facilitate all HEDIS Measure Eye Exam for Patients with Diabetes (EED) related initiatives
- Serve as a liaison to support all health management programs and quality improvement activities as directed by the VP of Clinical Programs and Vision Clinical Quality Team
- Oversee all department HEDIS reports and analyses
- Coordinate HEDIS outreach efforts
- Facilitate HEDIS preparation and data collection for annual chart review efforts
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:
- Certified Ophthalmic Assistant or Technician (COA or COT) credentials
- 3+ years of eyecare knowledge and vision billing experience
- Ability to create and present presentations to health plan clients and vision team
- Proven analytical, critical thinking, and problem-solving skills
- Ability to lead monthly meetings on HEDIS EED initiatives
- Proficiency in using Microsoft Office applications; Word, Excel, PowerPoint, Outlook
Preferred Qualifications:
- Understands the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards and HIPAA
- Knowledge of federal, national, state, and health plan regulatory requirements, as well as managed care and health plan standards
- Vision billing/coding experience
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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.