Clinical Abstractor

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The IOA assists providers in targeting those patients that have gaps in HEDIS measures and/or have not been seen in the office within the last year. IOA also helps providers improve the accuracy of risk adjustment documentation and abstraction and maximize the health plan indicator scores in the Centers for Medicare & Medicaid Services (CMS) Five Star Quality Rating System. The provider can bring the patient in for a comprehensive exam while also offering treatment in alignment with the NCQA measurements. This information is then reported back to Optum for coding for risk adjustment and HEDIS reporting.

Primary Responsibilities:

• Abstracts patient charts and pull the information from the chart so it can be submitted to the NCQA during the PSV audit. This function is accomplished in a prompt and reasonable timeframe in accordance with productivity and accuracy standards
• Synopsize important information from patient records for accuracy
• Reviewing medical records and abstracting necessary information to close the gap on the quality measure
• Keep abreast of the guidelines and updates
• Update skill and knowledge levels in accordance with NCQA
• Complies with confidentiality standards and HIPAA privacy regulations
• Perform other tasks and projects as needed by chart operations
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Eligibility

To apply to an internal job, employees must meet the following criteria:

• Candidates at SG22 can apply; grade movement will be as per IJP policy:
  • SG22 will move laterally
• ME 3 and above in last Common review cycle
• Not on Active CAP or Active disciplinary action
• Time in Role Guidelines
  • Should have been in your current position for a minimum of 12 months, if you have not met the recommended minimum time in role, discuss your career interest with your manager and gain alignment prior to applying. And share the alignment email with respective recruiter while applying

Required Qualifications:

• Graduation from Lifescience Background / Medical allied 
• Proficient computer skills
• Proven attention to detail
• Proven good communication skills (both verbal and written)

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.