UnitedHealth Group.

  • Dallas, TX


  • Long-term.

  • Full-time.

Do you have empathy and an enthusiasm to assist others? Changing health care and countless lives as an outcome begins with the worths you accept and the enthusiasm you give accomplish your life’s finest work.( sm)

The Sr. Medical Coding Nurse Expert will drive constant, effective procedures and share finest practices in a collective effort with Suppliers and Market Group, developed to assist in accomplishment of objectives set for HCC Ratio, HCC Covered Ratio, and HCC Percent Covered. The Sr. Medical 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 supply instructions and assistance to Medical Coding Experts, along with cross practical employee within their particular Markets relating to Danger Change.

$5,000 Sign-On Bonus Offer for External Candidates!

Main Obligations:

  • Establish and execute market organization strategies to encourage companies to take part in enhancing Danger Modification metrics
  • Supply analytical analysis of Threat Modification reporting consisting of, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to strategy and supplier groups
  • Subject Professional (SME) for all Threat Change 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 through Supplier education sessions and Doctor Organization Conferences/ JOCs
  • Lead Weekly, Month-to-month, Bi-monthly, Quarterly, and/ or Yearly Organization Evaluation conferences associated with Danger Change activities which sum up company group efficiency and market efficiency as asked for by or needed by Market management
  • Examine and assess supplier group structure and attributes, company group/ company workplace operations and workers to determine the most efficient techniques and methods associated with Threat Modification
  • Analyze Supplier and Group efficiency concerning Danger Modification and Concentrate On Care (FOC) to identify 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 Professional records
  • Deal With DataRAP Senior Management on determined unique job

You’ll be rewarded and acknowledged for your efficiency in an environment that will challenge you and provide 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.

Needed Credentials:

  • Bachelor’s degree in Nursing (Partner 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 Texas or Compact Registered Nurse license in excellent standing
  • Should have a CPC accreditation or have the capability to get an accreditation within 9 months of work from the American Academy of Expert Coders
  • 1 years of ICD-9, ICD10 coding experience
  • 5 years of associated company experience within the healthcare market
  • Understanding of CMS HCC Design and Standards in addition to ICD 10 Standards
  • 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 identified by company requirements
  • Reputable transport that will allow you to take a trip to customer and/ or client websites within a designated location
  • You will be asked to perform this function in a workplace setting or other business place
  • Staff members are needed to evaluate for signs utilizing the ProtectWell mobile app, Interactive Voice Action (i.e., entering your signs by means of phone system) or a comparable UnitedHealth Group authorized sign screener prior to getting in 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 obtained

Preferred Certifications:

  • 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 engage with medical personnel, peers, and internal business personnel at all levels
  • Capability to resolve procedure issues crossing several practical locations and organization systems
  • Strong analytical abilities: the capability to examine issues, draw pertinent conclusions and design and execute a proper strategy
  • Excellent organization acumen, particularly as it associates with Medicare
  • Medical/ scientific background
  • MS Workplace Suite, moderate to sophisticated EXCEL and PowerPoint abilities
  • Extra Medical chart evaluation experience
  • Expert experience convincing modifications in habits

Professions with WellMed. Our focus is easy. We’re innovators in preventative healthcare, making every effort to alter the face of healthcare for elders. 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 service providers and personnel are picked for their devotion and concentrate on preventative, proactive care. For you, that indicates one extraordinary group and a particular chance to do your life’s finest work.( sm)

WellMed was established in 1990 with a vision of being a physician-led business that might alter the face of health care shipment for senior citizens. Through the WellMed Care Design, we concentrate on assisting our clients remain healthy by supplying the care they require from physicians who appreciate them. We partner with numerous Medicare Benefit health insurance in Texas and Florida and anticipate continuing development.

PLEASE KEEP IN MIND The indication on reward 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 reward.

Variety develops 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, safeguarded experienced status, impairment status, sexual preference, gender identity or expression, marital status, hereditary details, 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, TX, Texas, Danger Change, Medical Record Evaluation, Chart Evaluation, Field, ICD-9, ICD-10, CPT, Dallas, Fort Worth, TX, Texas.

UnitedHealth Group.

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