UnitedHealth Group.

  • San Antonio, TX


  • Long-term.

  • Full-time.

For those who wish to develop the future of healthcare, here’s your chance. We’re surpassing standard care to health programs incorporated throughout the whole continuum of care. Join us and assist individuals live much healthier lives while doing your life’s finest work.( sm)

The Coding Nurse Specialist will drive constant, effective procedures and share finest practices in a collective effort with Companies and Market Group, created to help with accomplishment of objectives set for HCC Ratio, HCC Covered Ratio, and HCC Percent Covered. The Sr. Scientific Coding Nurse Expert will drive Danger Change enhancement efforts, establish suggestions for Threat Modification removal strategies and develop tools and databases to record appropriate information for appointed markets to attain business and market particular Threat Change objectives and efforts. This position will work collaboratively with each local/ market group and their management in a matrix relationship. This position will supply instructions and assistance to Medical Coding Experts, in addition to cross practical staff member within their particular Markets relating to Threat Modification.

Main Obligations:

  • Establish and execute market service strategies to inspire suppliers to take part in enhancing Threat Change metrics
  • Offer analytical analysis of Danger Change reporting consisting of, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to strategy and company groups
  • Subject Professional (SME) for all Threat Modification associated activities within their appointed market( s) working within a matrix relationship that includes DataRAP operations and Regional/ Market operations
  • Help in establishing of training and analytical products for Danger Change
  • Supervise DataRAP training and education shipment for Mega Groups by means of Service provider education sessions and Doctor Company Conferences/ JOCs.
  • Lead Weekly, Month-to-month, Bi-monthly, Quarterly, and/ or Yearly Service Evaluation conferences connected to Threat Modification activities which sum up supplier group efficiency and market efficiency as asked for by or needed by Market management
  • Evaluate and assess service provider group structure and attributes, service provider group/ supplier workplace operations and workers to determine the most efficient techniques and methods connected to Danger Change
  • Analyze Company and Group efficiency concerning Danger Change and Concentrate On Care (FOC) to figure out locations of focus or enhancement chances.
  • Establish solution-based, easy to use efforts to support practice success
  • Manage market particular chart retrieval and evaluation of PCP, Health Center, and Expert records
  • Deal With DataRAP Senior Management on recognized unique job

You’ll be rewarded and acknowledged for your efficiency in an environment that will challenge you and offer you clear instructions on what it requires to be successful in your function along with supply advancement for other functions you might have an interest in.

$5,000 Indication on Bonus Offer for External Candidates

Needed Credentials:

  • Bachelor’s Degree in Nursing needed (Partner’s Degree or Nursing Diploma from recognized nursing school with 2 or more years of extra experience might be replaced in lieu of a bachelor’s degree) and present Registered Nurse license in excellent standing needed
  • CPC accreditation or evidence that accreditation has actually been acquired within 9 months from date of hire from the American Academy of Expert Coders needed
  • Minimum of 1 year of orientation with ICD10 codes
  • Minimum of 5 years associated nursing experience within a healthcare market
  • Expert experience encouraging modifications in habits
  • Strong understanding of the Medicare market, items, and rivals
  • Understanding base of scientific requirements of care and preventative health procedures
  • Capability and determination to take a trip (in your area and non-locally) as figured out by company requirements
  • Staff members are needed to evaluate for signs utilizing the ProtectWell mobile app, Interactive Voice Reaction (i.e., entering your signs by means of phone system) or a comparable UnitedHealth Group-approved sign screener prior to going into the work website every day, in order to keep our work websites safe. Workers should adhere to any state and regional masking orders. In addition, when in a UnitedHealth Group structure, workers are anticipated to use a mask in locations where physical distancing can not be achieved

Preferred Credentials:

  • Bachelor’s degree
  • Experience in handled care dealing with network and service provider relations
  • Strong discussion abilities and relationship structure abilities with scientific/ non-clinical workers
  • Shown capability to communicate with medical personnel, peers, and internal business personnel at all levels
  • Capability to fix procedure issues crossing several practical locations and service systems
  • Strong analytical abilities; the capability to evaluate issues, draw appropriate conclusions and create and carry out a suitable strategy
  • Great company acumen, specifically as it connects to Medicare
  • Medical/ medical background
  • MS Workplace Suite, moderate to innovative EXCEL and PowerPoint abilities
  • Extra Medical chart evaluation experience
  • Expert experience convincing modifications in habits

Professions with WellMed. Our focus is basic. We’re innovators in preventative healthcare, aiming to alter the face of healthcare for senior citizens. We’re affecting 550,000 lives, mostly Medicare qualified elders in Texas and Florida, through main and multi-specialty centers, and contracted medical management services. We have actually signed up with Optum, part of the UnitedHealth Group household of business, and our objective is to assist the ill ended up being well and to assist clients comprehend and manage their health in a long-lasting effort at health. Our suppliers and personnel are chosen for their devotion and concentrate on preventative, proactive care. For you, that implies one extraordinary group and a particular chance to do your life’s finest work.( sm)

PLEASE KEEP IN MIND The indication on benefit is just offered to external prospects. Prospects who are presently working for a UnitedHealth Group, UnitedHealthcare or an associated entity in a full-time, part-time, or daily basis (” Internal Prospects”) are not qualified to get an indication on bonus offer.

Variety produces a much healthier environment: UnitedHealth Group is an Equal Job Opportunity/ Affirmative Action company and all certified candidates will get factor to consider for work without regard to race, color, faith, sex, age, nationwide origin, secured seasoned status, impairment status, sexual preference, gender identity or expression, marital status, hereditary info, or any other particular secured by law.

UnitedHealth Group is a drug-free office. Prospects are needed to pass a drug test prior to starting work.

Task Keywords: Registered Nurse, Registered Nurse, CPC, Coding, San Antonio, TX, Texas, Threat Modification, Medical Record Evaluation, chart evaluation, field, ICD-9, ICD-10, CPT.

UnitedHealth Group.

  • View & Apply.