Quality Performance Medical Assistant | Irvine, CA

Quality Performance Medical Assistant

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The Quality Performance Medical Assistant is responsible to support data-driven strategies and workplans that improve the health, well-being, and quality of care and service received by our Medi-Cal members, as demonstrated by high quality measure performance. This role will collaborate with internal and external key stakeholders, regional operations, IPA practices, FQHCs, and other community partners, to drive clinical relationships and engagements between members and their care delivery system. This focus of this role is Medi-Cal quality metric performance, which may include but is not limited to HEDIS and CMS Measure gap closure, and CAHPS/HOS patient experience performance.

The ideal candidate will be:

• Self-directed, able to manage multiple priorities, and coordinate complex cross-functional project plans, in order to drive execution of PI strategies
• Accountable for improvement on HEDIS and STARs gap closure, improved patient experience and optimized patient outcomes
• Skilled at utilizing data to drive decisions, and has a passion for applying technology to achieve systematic solutions
• Passionate about continuous improvement, streamlined processes and workflow optimization
• Energized by new challenges, thrives in a fast-paced, dynamic environment, collaborates well in a team-oriented atmosphere

Primary Responsibilities:

Under the supervision of the VP, Government Programs and in collaboration with other stakeholders, the Quality Performance Medical Assistant will support data-driven strategies and workplans that improve the overall health and service provided to our Medi-Cal patients. The goals of the program may include:

• Supports quality performance measures (e.g., HEDIS, CMS, CAHPS) by engaging members assigned to targeted practices and supporting their improvement workplans
• Ensures member outreach programs are successfully executed in a timely manner
• Supports data reconciliation between clinical practices and Optum internal quality reporting through chart review and supplemental data entries
• Supports programs integrating in-office embedded and wrap-around support including but not limited to blood pressure checks, lab draws, patient scheduling, chart reviews, targeted mailings and IVR campaigns, workflow optimization and visible performance tracking
• Collaborates and aligns strategies with other regional support teams (e.g., Provider Relations and Population Health)
• Maintains performance tracking related to assigned projects to ensure timely and accurate execution and required documentation; uses performance reports to track and trend progress
• Participates in required meetings related to Medi-Cal Pay for Value (P4V) performance, measure updates, etc.
• Stays informed on all member outreach activities and communication schedules
• Supports continuous performance improvement through research and testing of new initiatives to assess success and scalability
• Provides continuous feedback to manager and team on performance, barriers, opportunities, and action plans for all assigned practices
• Other 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:

• Medical Assistant certified, with ability to draw patient labs and take Blood Pressure
• 1+ years working with programs in HEDIS Quality, Stars, CAHPS/HOS experience
• Verbal fluency in Spanish
• Experience with managed healthcare / care delivery business operations
• Prior experience working directly with clinicians, provider practices and/or care delivery networks
• Intermediate MS Office skills
• Valid CA Driver's license, current insurance and reliable transportation to local provider offices

Preferred Qualifications

• Provider office administrative or call center experience
• Experience with Technology-based Solutions (EHRs, IVR, Texting Applications, etc.)
• Excellent communication skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $16.15 to $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.