Optumcare Coding Educator - Local Travel - West Valley City, UT

Unitedhealth Group Inc. West Valley City , UT 84119

Posted 3 months ago

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Are you ready for a new path? Start doing your life's best work.(sm)

This position is responsible for the direction and guidance on risk adjustment documentation to contracted network providers utilizing chart reviews, Optum metrics, and CMS guidelines emphasizing the importance of RAF and HCC recapture. Conducts clinical quality audits regarding CRC documentation following CMS guidelines. Responsible to report and analyze provider documentation quality and for the development of plans and programs to support continuous quality improvement. The Coding Educator provides support and works in conjunction with the Clinician Educator to facilitate meeting Optum's overall goal of RAF improvement through quality documentation in the Utah market.

  • This position requires local travel throughout the WVC / SLC market, Mon.
  • Fri.

General Job Profile

  • Reviews provider charts for documentation to support RAF recapture

  • Develops innovative approaches to facilitate the ongoing training of network providers and support staff

  • Sought out as expert on CMS coding regulations and guidelines

  • Serves as a resource for network managers, clinic staff, network providers and Clinician Educators

  • Conducts education to network providers and support staff

Job Scope and Guidelines

  • Familiarity with local market network providers, clinics, politics, and other factors influencing healthcare delivery in the Utah market

  • Establish and maintain professional relationships with all stakeholders

  • Serves as a key resource for network providers, network administrative and coding staff regarding RAF and coding guidelines

  • Continuously up to date on coding principles following CMS guidelines

  • Fluent and proficient in network database management using Optum software and various other applicable programs

  • Educate network providers, clinical and administrative staff on CMS coding and documentation guidelines through various formats (i.e. clinic visitation, RAF education events, small group coder session, one-on-one provider consultations)

  • Utilize individual chart reviews, Optum data, and approved education materials to develop training and educational interventions for network providers

Required Qualifications:

  • 2 years of experience with Risk Adjustment and HEDIS / Stars

  • 2 years of clinical experience, either hospital, ambulatory clinic and/or managed care experience

  • Undergraduate degree or equivalent experience

  • Certified Professional Coder with American Health Information Management Association or American Academy of Professional Coders, CRC (Certified Risk

  • Adjustment Coder) or willingness to obtain required certification within the first year in the position
  • Knowledge of ICD-10

  • Strong proficiency in MS Office (Excel, PowerPoint, Word and Outlook)

  • Ability to travel within the local market

  • Able to travel to network clinics during work day to provide educational training

Preferred Qualifications:

  • Demonstrate a level of knowledge and understanding of ICD-10 coding principles and Medicare guidelines

  • DataRAP, EnCoder and EMR / HER experience is preferred

  • Relationship sales background

  • Strong communication skills and demonstrated ability to work well with teams

  • Ability to formulate training materials designed to improve provider compliance

  • Ability to use independent judgment and discreetly manage and impart confidential information

  • Good work ethic, desire to succeed, self-starter and can work independently

  • Must be able to work effectively with common office software, market EMR systems, and reporting systems

  • Ability to develop and maintain long term business relationships

  • Excellent oral and written communication skills, including experience giving group presentations

  • Ability to collaborate with individuals or teams to produce quality results

  • Strong business acumen and analytical skills

  • General knowledge of HEDIS/Stars guidelines and CPT 2 codes

  • Experience in a managed care or medical insurance setting

  • Good organization and planning skills, the ability to adhere to a full schedule

  • Ability to present complex data clearly and concisely to external clients

  • Willingness to become credentialed as a CPC-I during the course of this position in order to offer CEU to community/ market coders as defined by market needs as determined by clinical education team.

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: Risk Adjustment coder, coding educator, providers, outpatient clinics, Risk Adjustment Supervisor, Clinical Documentation Manager, Quality Improvement Supervisor, Quality Assurance, RHIT, CCS, CPC, AAPC, AHIMA


See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
FullTime Territory Retail Lead West Valley City UT

Anderson Merchandisers

Posted 6 days ago

VIEW JOBS 11/11/2018 12:00:00 AM 2019-02-09T00:00 Territory Sales Lead About Anderson Merchandisers We've been around for 100 years and became the nation's largest merchandiser of entertainment products. We now represent many different clients in multiple retail chains. We pride ourselves on an unparalleled ability to deliver best-in-class in-store execution to increase our client's and retailer's sales. We are a family company in more than just name. At Anderson Merchandisers, your success is our success. Simply put, we are who you are. Some of our biggest business-building ideas have come directly from our associates. When it comes down to it, it is our people who make our company great. SUMMARY: The majority of responsibility for the Territory Sales Lead is the supervision and development of the assigned associates to drive sales and meet retailer and client expectations. The Territory Sales Lead will also be responsible for project completion, stocking and maintaining the areas we are responsible for. This responsibility is demonstrated by effectively selling and educating customers and store personnel about product lines and other project (s) deemed necessary. The Territory Sales Lead reports directly to the District Sales Manager. IND-123 DUTIES and RESPONSIBILITES include but are not limited to the following: * Build rapport through daily communication with store associates and management. * Train, supervise, and develop skills of Sales Merchandisers, fellow Territory Sales Leads, and seasonal associates. * Educate customers and store personnel on the features and benefits of our client's brands and product lines. * Lead, coach, and execute all projects in all areas of the store to meet or exceed client expectations. * Have detailed knowledge of all company policies. * Communicate successes or potential barriers to the District Sales Manager. * Knowledgeable, detailed understanding and consistent use of all available functions of handheld device. * Maintain company, client and retailer confidentiality. COMPETENCIES: To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position: * Problem solving - the individual identifies and resolves problems in a timely manner, gathers and analyzes information skillfully and maintains confidentiality. * Interpersonal skills - the individual maintains confidentiality, remains open to others' ideas, and exhibits willingness to try new things. * Oral communication - the individual speaks clearly and persuasively in positive or negative situations. * Written communication - the individual edits work for spelling and grammar, presents numerical data effectively, and is able to read and interpret written information. * Quality control - the individual demonstrates accuracy and thoroughness and monitors their own work to ensure quality. * Planning/organizing - the individual prioritizes and plans work activities and uses time efficiently. * Adaptability - the individual adapts to changes in the work environment, manages competing demands, and is able to deal with frequent change, delays or unexpected events. * Dependability - the individual is consistently at work and on time, follows instructions, responds to management direction, and solicits feedback to improve. * Sense of urgency – individual must possess the ability to prioritize effectively and with a strong sense of urgency. They must also respond/react quickly to any specific requests. * Integrity - the individual acts in such a way that instills trust from management, other associates, as well as customers. Acts with honesty while assisting customers, processing transactions, handling money, and confidential information. * Teamwork - the individual has the ability to work with others including partners, vendors and customers in a positive manner. They understand others' roles and empower one another to take responsibility to be a successful team. Demonstrates a collaborative interaction with peers to reach a common goal. REQUIREMENTS and QUALIFICATIONS, including but not limited to the following: * Lifting objects and product up to a maximum of 50 lbs. with frequent lifting and/or carrying of objects/product up to 35 lbs, in addition, the ability to lift heavy objects up to 100lbs with assistance from another associate. * Work performed could be while sitting, standing, or walking. * Work performed will entail fine manipulation of hands or fingers, bending, twisting, squatting, and climbing as well as upper and lower body mobility. * Experience/comfort level with electronics/technical products. * Independent and self-motivated. * Must be able to work a flexible schedule, including nights and weekends. * High School diploma or equivalency certification required. * Valid driver's license is required as travel to additional locations may be necessary. * Automobile liability insurance is required to be maintained. * Computer, printing capability, internet access, and email required. * Access to webcam preferred. * Customer service or sales experience required. IND-123 Retail Execution West LLCSales Anderson Merchandisers West Valley City UT

Optumcare Coding Educator - Local Travel - West Valley City, UT

Unitedhealth Group Inc.