UnitedHealth Group.

  • San Antonio, TX


  • Irreversible.

  • Full-time.

For those who wish to create the future of healthcare, here’s your chance. We’re exceeding fundamental 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 Sr. Medical Coding Nurse Specialist will drive constant, effective procedures and share finest practices in a collective effort with Service providers and Market Group, created to assist in accomplishment of objectives set for HCC Ratio, HCC Covered Ratio, and HCC Percent Covered. The Sr. Scientific Coding Nurse Expert will drive Danger Modification enhancement efforts, establish suggestions for Danger Change removal strategies and develop tools and databases to record appropriate information for appointed markets to accomplish business and market particular Danger Change objectives and efforts. This position will work collaboratively with each local/ market group and their management in a matrix relationship. This position will offer instructions and assistance to Medical Coding Experts, in addition to cross practical staff member within their particular Markets referring to Threat Change.

Main Obligations:

  • Establish and carry out market company strategies to encourage suppliers to take part in enhancing Danger Modification metrics
  • Offer analytical analysis of Threat Change reporting consisting of, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to strategy and company groups
  • Topic Professional (SME) for all Danger 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 Threat Modification
  • Supervise DataRAP training and education shipment for Mega Groups through Service provider education sessions and Doctor Service Conferences/ JOCs.
  • Lead Weekly, Month-to-month, Bi-monthly, Quarterly, and/ or Yearly Company Evaluation conferences associated with Threat Modification activities which sum up company group efficiency and market efficiency as asked for by or needed by Market management
  • Evaluate and examine supplier group structure and qualities, supplier group/ company workplace operations and workers to determine the most reliable methods and techniques connected to Threat Modification
  • Analyze Service provider and Group efficiency relating to Danger Change and Concentrate On Care (FOC) to identify locations of focus or enhancement chances.
  • Establish solution-based, easy to use efforts to support practice success
  • Supervise market particular chart retrieval and evaluation of PCP, Healthcare Facility, and Professional records
  • Deal With DataRAP Senior Management on recognized unique task

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 prosper in your function along with supply advancement for other functions you might have an interest in.

$5,000 Indication on Perk 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 existing Registered Nurse license in great standing needed
  • CPC accreditation or evidence that accreditation has actually been gotten 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 medical requirements of care and preventative health procedures
  • Capability and determination to take a trip (in your area and non-locally) as identified by company requirements
  • Workers 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. Staff members need to abide by any state and regional masking orders. In addition, when in a UnitedHealth Group structure, staff members 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 supplier relations
  • Strong discussion abilities and relationship structure abilities with scientific/ non-clinical workers
  • Shown capability to engage with medical personnel, peers, and internal business personnel at all levels
  • Capability to resolve procedure issues crossing numerous practical locations and service systems
  • Strong analytical abilities; the capability to examine issues, draw appropriate conclusions and design and carry out a proper strategy
  • Great organization acumen, specifically as it connects to Medicare
  • Medical/ scientific 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, making every effort to alter the face of healthcare for elders. We’re affecting 550,000 lives, mainly Medicare qualified senior citizens 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 commitment and concentrate on preventative, proactive care. For you, that indicates one unbelievable group and a particular chance to do your life’s finest work.( sm)

PLEASE KEEP IN MIND The indication on perk 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.

To learn more on our Internal Task Post Policy,.

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 work environment. Prospects are needed to pass a drug test prior to starting work.

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

UnitedHealth Group.

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