UnitedHealth Group

UnitedHealth Group.

  • Houston, TX


  • Irreversible.

  • Full-time.

For those who wish to create 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 Sr. Medical Coding Nurse Specialist will drive constant, effective procedures and share finest practices in a collective effort with Service providers 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 Threat Modification removal strategies and develop tools and databases to record appropriate information for designated markets to accomplish business and market particular Threat Modification objectives and efforts. This position will work collaboratively with each regional/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 employee within their particular Markets referring to Danger Change.

$5,000 Sign-On Reward For External Prospects

Main Obligations:

  • Establish and carry out market service strategies to inspire companies to take part in enhancing Threat Change metrics
  • Offer analytical analysis of Danger Modification reporting consisting of, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to strategy and supplier groups
  • Topic Professional (SME) for all Threat Modification associated activities within their designated 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 Change
  • Manage DataRAP training and education shipment for Mega Groups through Service provider education sessions and Doctor Service Conferences/ JOCs
  • Lead Weekly, Month-to-month, Bi – month-to-month, Quarterly, and/or Yearly Service Evaluation conferences associated with Threat Modification activities which sum up supplier group efficiency and market efficiency as asked for by or needed by Market management
  • Examine and examine service provider group structure and attributes, company group/provider workplace operations and workers to recognize the most reliable techniques and techniques associated with Threat Modification
  • Analyze Supplier and Group efficiency concerning 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
  • Manage market particular chart retrieval and evaluation of PCP, Medical Facility, and Expert records
  • Deal With DataRAP Senior Management on recognized unique tasks

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 offer 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 existing Registered Nurse license in great standing
  • CPC accreditation or evidence that accreditation has actually been acquired within 9 months from the American Academy of Expert Coders
  • 1 years of ICD-9, ICD10 coding experience
  • 5 years associated organization experience with healthcare market
  • Understanding of CMS HCC Design and Standards in addition to ICD 10 Standards
  • 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 steps
  • Capability and determination to take a trip (in your area and non – in your area) as figured out by service requirements
  • Workers are needed to evaluate for signs utilizing the ProtectWell mobile app, Interactive VoiceResponse (i.e., entering your signs through 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. Staff members should 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
  • You will be provisioned with proper Individual Protective Devices (PPE) and are needed to perform this function with clients and members on website, as this is a vital function of this function
  • This position needs Tuberculosis screening in addition to evidence of resistance to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through laboratory verification of resistance, recorded proof of vaccination, or a medical professional’s medical diagnosis of illness.

Preferred Credentials:

  • Experience in handled care dealing with network and company relations
  • Strong discussion abilities and relationship structure abilities with scientific/ non-clinical workers
  • Shown capability to connect with medical personnel, peers, and internal business personnel at all levels
  • Capability to fix procedure issues crossing numerous practical locations and organization systems
  • Strong issue – fixing abilities; the capability to evaluate issues, draw appropriate conclusions and create and carry out a suitable strategy
  • Excellent company acumen, particularly as it connects to Medicare
  • Medical/ scientific background extremely preferable
  • Bachelor’s degree chosen
  • MS Workplace Suite, moderate to innovative EXCEL and PowerPoint abilities
  • Extra Medical chart evaluation experience

Physical & Mental Requirements:

  • Capability to raise to 10 pounds
  • Capability to press or pull heavy items consuming to pounds of force
  • Capability to sit for prolonged amount of times
  • Capability to represent prolonged amount of times
  • Capability to utilize great motor abilities to run devices and/ or equipment
  • Capability to correctly drive and run a business lorry
  • Capability to get and understand directions verbally and/ or in composing
  • Capability to utilize sensible thinking for easy and complicated issue fixing

Professions with WellMed. Our focus is basic. We’re innovators in preventative healthcare, making every effort to alter the face of healthcare for senior citizens. We’re affecting 550,000 lives, mostly 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 implies one amazing group and a particular chance to do your life’s finest work.( sm)

To learn more on our Internal Task Post Policy,.

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 Reward.

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

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

Task Keywords: Registered Nurse, Quality Registered Nurse, Registered Nurse, DataRAP, ICD-10, Service provider danger modification coding, Company Education, HCC codes, center audits, Houston TX.

UnitedHealth Group.

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