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Admin / Support Specialist - Healthcare - La Palma, CA

UnitedHealth Group

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Job Details

752355 Admin Support Specialist Healthcare La Palma CA

Admin / Support Specialist - Healthcare - La Palma, CA (752355)

Position Description

AppleCare Medical Management Group was incorporated in 2003. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.


Performs office support activities for the Clinical Documentation & Quality Improvement (CDQI) Department. Duties may include running reports, creating spreadsheets and presentations, coordinating risk adjustment and quality programs, faxing, logging and reconciling invoices. Extensive software skills are required, as well as Internet research abilities and strong communication skills.
Primary Responsibilities:
  • Validate charts pulled by Clerical Coordinator for health plan chart audits
  • Prepare and send new member lists to vendor monthly
  • Prepare member mailings for risk adjustment programs
  • Prepare and send chart chase lists to vendor
  • Reconcile Health Plan Annual Wellness Exams
  • Run macro to rename files to AppleCare naming convention
  • Prepare and send Health Plan Annual Wellness Exam forms to vendor weekly
  • Update Long Term Care & Skilled Nursing log with added/deleted members each month
  • Request attestation forms for members admitted to Long Term Care/Skilled Nursing facilities each month
  • Distribute Long Term Care/Skilled Nursing attestation forms to the Nurse Practitioners each month
  • Track Long Term Care and Skilled Nursing visits
  • Send Completed Long Term Care and Skilled Nursing visit forms to Health Plan
  • Send Health Plan Annual Wellness Exams to Vendor for coding
  • Send completed attestations to Health Plan Weekly
  • Track submissions to Health Plan, Queries from Health Plan and payments
  • Reconcile and log vendor invoices
  • Take Department phone calls
  • Validate member mailings for Quality Initiatives
  • Collaborate with quality team to prepare ad-hoc and/or existing quality reports
  • Run macro to split files by HP and by professional/institutional
  • Submit files to health plans
  • Data entry
  • Other duties as assigned
Required Qualifications:
  • High School Diploma/GED or equivalent experience
  • At least 1 year of experience in a hospital, medical group, health plan or IPA setting. (2 years preferred)
  • Intermediate proficiency in Word and Excel
Preferred Qualifications:
  • Bachelor's degree
  • Intermediate skills in Outlook and Power Point.
  • Knowledge of general IPA operations
  • Experience with Risk Adjustment and STARS/P4P/HEDIS a plus

Soft Skills required:

  • Work does not usually require established procedures
  • Works independently
  • Acts as a resource and mentors for others
  • Coordinates work activities
  • Applies knowledge/skills to complex activities
  • Demonstrates a depth and breadth of knowledge/skills in own area and is often able to these outside of own function.
  • Often acts as a technical resource to others in own function.
  • Anticipates customer needs and proactively identifies solutions.
  • Solves complex problems on own; proactively identifies new solutions to problems.
  • Plans, prioritizes, organizes and completes work to meet established objectives.
  • Acts as a facilitator to resolve conflicts on team; seen as key team member on project teams spanning more than own function.
  • Able to multitask in demanding atmosphere
  • Dependable, punctual and willing to adapt to changing itineraries
  • Ability to seek answers and advice in areas where questions arise

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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.



Job Keywords: Hospital, medical group. Healthcare, coordinator, IPA, administrative, Excel, PowerPoint, risk adjustment, adhoc reports, STARS, P4P, HEDIS, La Palma, CA, California

Job Details

  • Contest Number752355
  • Job TitleAdmin / Support Specialist - Healthcare - La Palma, CA
  • Job FamilyBusiness Operations
  • Business SegmentOptumCare

Job Location Information

    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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