UnitedHealth Group

UnitedHealth Group.

  • Houston, TX


  • Long-term.

  • Full-time.

For those who wish to create the future of healthcare, here’s your chance. We’re exceeding 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. Scientific 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. Scientific Coding Nurse Specialist will drive Danger Change enhancement efforts, establish suggestions for Danger Modification removal strategies and produce tools and databases to catch pertinent information for designated markets to attain 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 supply instructions and assistance to Medical Coding Experts, along with cross practical staff member within their particular Markets referring to Danger Change.

$5,000 Sign-On Bonus Offer For External Prospects

Main Obligations:

  • Establish and execute market organization strategies to inspire companies to participate in enhancing Danger Change metrics
  • Supply analytical analysis of Threat Modification reporting consisting of, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to strategy and company groups
  • Subject Specialist (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 Threat Change
  • Manage DataRAP training and education shipment for Mega Groups through Service provider education sessions and Doctor Organization Conferences/ JOCs
  • Lead Weekly, Month-to-month, Bi – month-to-month, Quarterly, and/or Yearly Organization Evaluation conferences connected to Danger Change activities which sum up service provider group efficiency and market efficiency as asked for by or needed by Market management
  • Evaluate and assess service provider group structure and qualities, supplier group/provider workplace operations and workers to determine the most reliable techniques and techniques associated with Danger Change
  • Analyze Service provider and Group efficiency relating to Threat 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
  • Supervise market particular chart retrieval and evaluation of PCP, Medical Facility, and Expert records
  • Deal With DataRAP Senior Management on recognized unique jobs

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

Needed Certifications:

  • Bachelor’s degree in Nursing (Partner degree or Nursing Diploma from certified 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 great standing
  • CPC accreditation or evidence that accreditation has actually been gotten 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 convincing 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 identified by company 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 going into the work website every day, in order to keep our work websites safe. Staff members need to adhere to 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 suitable Individual Protective Devices (PPE) and are needed to perform this function with clients and members on website, as this is a necessary 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 physician’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 resolve procedure issues crossing numerous practical locations and company systems
  • Strong issue – fixing abilities; the capability to evaluate issues, draw pertinent conclusions and design and execute a suitable strategy
  • Excellent organization acumen, specifically as it connects to Medicare
  • Medical/ medical background extremely preferable
  • Bachelor’s degree chosen
  • MS Workplace Suite, moderate to sophisticated 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 guidelines verbally and/ or in composing
  • Capability to utilize sensible thinking for easy and complicated issue resolving

Professions with WellMed. Our focus is easy. 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 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 companies 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)

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 Benefit.

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, religious beliefs, sex, age, nationwide origin, secured experienced status, special needs status, sexual preference, gender identity or expression, marital status, hereditary details, 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, Company danger modification coding, Company Education, HCC codes, center audits, Houston TX.

UnitedHealth Group.

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