UnitedHealth Group

UnitedHealth Group.

  • Midland, 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 welcome and the enthusiasm you give attain your life’s finest work.( sm)

The Sr. Scientific Coding Nurse Specialist will drive constant, effective procedures and share finest practices in a collective effort with Service providers 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 Change removal strategies and produce tools and databases to catch pertinent information for appointed markets to accomplish 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 offer instructions and assistance to Medical Coding Experts, in addition to cross practical employee within their particular Markets referring to Threat Modification.

This positon will cover clincis in the Midland and Odessa location.

Main Duties:

  • Establish and carry out market organization strategies to encourage suppliers to participate in enhancing Threat Change metrics
  • Offer analytical analysis of Threat Change reporting consisting of, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to strategy and service provider groups
  • Topic Professional (SME) for all Danger Change 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 Organization Conferences/ JOCs.
  • Lead Weekly, Regular Monthly, Bi-monthly, Quarterly, and/ or Yearly Company Evaluation conferences associated with Danger Modification activities which sum up supplier group efficiency and market efficiency as asked for by or needed by Market management
  • Evaluate and examine service provider group structure and attributes, company group/ supplier 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
  • Supervise market particular chart retrieval and evaluation of PCP, Health Center, and Professional 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 provide you clear instructions on what it requires to prosper in your function in addition to offer advancement for other functions you might have an interest in.

Needed Credentials:

  • Bachelor’s degree in Nursing (Partner degree or Nursing Diploma from certified nursing school with 2 years of extra experience might be replaced in lieu of a bachelor’s degree) and existing Texas or Compact Registered Nurse license in great standing
  • Hold a CPC accreditation or have the capability to acquire an accreditation within 9 months of work from the American Academy of Expert Coders
  • 5 years of associated organization experience within the healthcare market
  • 1 years of ICD-9, ICD10 coding experience
  • 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 organization requirements
  • Trustworthy transport that will allow you to take a trip to customer and/ or client websites within a designated location

Preferred Certifications:

  • Bachelor’s degree
  • 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 engage with medical personnel, peers, and internal business personnel at all levels
  • Capability to resolve procedure issues crossing numerous practical locations and organization systems
  • Strong analytical abilities; the capability to evaluate issues, draw pertinent conclusions and develop and carry out a suitable strategy
  • Great company acumen, specifically as it associates with 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 elders. We’re affecting 550,000 lives, mainly 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 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)

To learn more on our Internal Task Post Policy,.

PLEASE KEEP IN MIND The indication on bonus offer 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 perk.

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 seasoned status, special needs 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, TX, Texas, Threat Modification, Medical Record Evaluation, chart evaluation, field, ICD-9, ICD-10, CPT, Midland, Odessa, TX, Texas.

UnitedHealth Group.

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