This role involves coordinating data gathering for HEDIS and STARs, reviewing medical records for quality, assisting with audits, and mentoring staff. It emphasizes data analysis and improving clinical documentation processes.
Requisition Number: 2358794
Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.
This position is responsible for the coordination of HEDIS and STARs data gathering process. This evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, identifying trends, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records. The Clinical Quality Coordinator will have a duty to provide a standard of care that meets or exceeds that of a reasonably competent and knowledgeable Medical Assistant.
Primary Responsibilities:
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:
Preferred Qualifications:
Physical & Mental Requirements:
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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 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 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.
UnitedHealth Group 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.
This position is responsible for the coordination of HEDIS and STARs data gathering process. This evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, identifying trends, maintaining accurate records of review activities, ensures all data submitted to the health plan meets the HEDIS/Star technical specifications for medical records. The Clinical Quality Coordinator will have a duty to provide a standard of care that meets or exceeds that of a reasonably competent and knowledgeable Medical Assistant.
Primary Responsibilities:
- Assisting in the review of medical records to highlight Star/HEDIS opportunities for the medical staff
- Review medical records for data collection, data entry, and quality monitoring including health plan/WellMed form submission and chart collection activities that close gaps in care
- Partner with the leadership team, the practice administrative or clinical staff to identify trends observed and potential strategies to support the practice
- Communicate scheduling challenges or trends that may negatively impact quality outcomes
- Track and trend barriers/challenges that exist at their assigned groups so that better outcomes can be achieved including access to appointments, lack of follow up on referrals, or inconsistent billing practices
- Activities may include data collection, data entry, quality monitoring, health plan/WellMed form submission and chart collection activities
- Assists with local IRR audits
- Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures
- Support chart chase process by requesting records from provider's offices as needed
- Maintains education/knowledge base of HEDIS/STARs
- 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 or GED
- Sustained Medical Assistant certification
- Current BLS certification
- 3+ years of healthcare experience to include experience in a managed care setting
- 3+ years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement
- 2+ years as a Certified Medical Assistant
- Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets
- Proven ability to mentor others
- Expert in computer literacy in electronic health record
- Knowledge of medical terminology
- This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease
Preferred Qualifications:
- Licensed Vocational/Registered Nurse, or Certified Professional Coder
- 1+ years of HEDIS/STAR experience or participation with similar regulatory reporting.
- 2+ years of college, in pursuance of a Bachelor's or Associate's degree.
- 2+ years of experience working with HEDIS/STAR measures.
- ICD 9/10 and CPT coding experience
- Experience working in a physician, provider, and/or medical office is preferred. EMR and HEDIS knowledge and experience
Physical & Mental Requirements:
- Ability to lift up to 10 pounds
- Ability to push or pull heavy objects using up to 50 pounds of force
- Ability to stand for extended periods of time
- Ability to use fine motor skills to operate equipment and/or machinery
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 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 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.
UnitedHealth Group 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Similar Jobs at Optum
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Quality Medical Assistant collaborates with physicians and clinic operations to facilitate preventive care, manage patient data, and ensure high standards of patient care delivery.
Top Skills:
Cpt CodingElectronic Health RecordsIcd-10MS Office
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Medical Assistant provides patient care, prepares examination rooms, maintains medical equipment, and supports clinical duties under provider supervision, ensuring quality customer service and confidentiality.
Top Skills:
Emr SystemsExcelOutlookWord
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The LVN provides clinical support and nursing care under the supervision of healthcare providers, coordinates patient care, and ensures compliance with health standards.
Top Skills:
Electronic Medical Records
What you need to know about the Boston Tech Scene
Boston is a powerhouse for technology innovation thanks to world-class research universities like MIT and Harvard and a robust pipeline of venture capital investment. Host to the first telephone call and one of the first general-purpose computers ever put into use, Boston is now a hub for biotechnology, robotics and artificial intelligence — though it’s also home to several B2B software giants. So it’s no surprise that the city consistently ranks among the greatest startup ecosystems in the world.
Key Facts About Boston Tech
- Number of Tech Workers: 269,000; 9.4% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Thermo Fisher Scientific, Toast, Klaviyo, HubSpot, DraftKings
- Key Industries: Artificial intelligence, biotechnology, robotics, software, aerospace
- Funding Landscape: $15.7 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Summit Partners, Volition Capital, Bain Capital Ventures, MassVentures, Highland Capital Partners
- Research Centers and Universities: MIT, Harvard University, Boston College, Tufts University, Boston University, Northeastern University, Smithsonian Astrophysical Observatory, National Bureau of Economic Research, Broad Institute, Lowell Center for Space Science & Technology, National Emerging Infectious Diseases Laboratories

