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Hours Full-time, Part-time
Location Philadelphia, PA
Philadelphia, Pennsylvania

About this job

What makes your Network career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting. OptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.


Primary responsibilities include:


-Provide ICD9 and ICD10 HCC coding training as requested by Market Consultative team

-Assist Market Consultants in managing provider relationships as related to CMS-HCC Risk Adjustment payment methodology, proper chart documentation, and diagnosis coding to revenue

-Deliver certification classes to coders

-Perform analysis and provide formal feedback of physician charts and coding

-Present information to external physicians regarding practices and programs

-Develop and deliver diagnosis coding tools to providers

-Develop and present coding presentations to large and small groups of clinicians, practice managers and certified coders.  Including, but not limited to 4 hour coding CEU certification course.  Training can include custom programs specific to provider's needs.

-Attend client meetings whenever a coding expert is required

-Attend and participate in internal coding forum discussions as scheduled

-Work collaboratively with the Clinical Team in development of disease specific training education and tools

-Participate in various courses (WebEx, live, self-paced, ULearn) to enhance skills as an expert consultant (i.e. communication, time management, negotiation tactics, influencing people, organization agility, presentation skills, technical learning)

-Maintain Coder certification

-Travel to perform coding training within Eastern, Central and Western Pennsylvania and Northern, Central and Southern New Jersey

-Field time may also be defined as completing provider visits either independent of or in collaboration with Market Consultants performing duties described above in primary responsibilities

-Field time may be required to conduct meetings equivalent to those that market consultants perform to engaged provider groups on various documentation and coding tools and programs

-Functioning independently, travel within Southeastern Pennsylvania to meet with assigned Provider groups to discuss OptumInsight tools and programs focused on improving the quality of care for Medicare Advantage Members.

-Utilizing data analysis, identify and target providers who would benefit from our Medicare Risk Adjustment training and documentation/coding resources.

-Educate providers on how to improve their Risk Adjustment Factor (RAF) scores and Quality metrics, which measure their patients' health status.

-Reach out to physicians, medical groups, IPAs and hospitals, to build positive, long-term, consultative relationships.

-Develop comprehensive, provider-specific plans for accurate reporting of chronic conditions.

-Train providers on our Risk Adjustment and Quality programs and tools, and work toward the adoption of these programs in to their practices.

-Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts.

 

  ** This role will require travel around Pennsylvania and New Jersey approximately 75% of the time**

 


Keywords: ICD10, ICD9, CPC, Certified Professional Coder, healthcare, trainer, provider education, provider relations


 

If you get excited about the life transforming potential of bringing health care information to the right place, at the right time, to support crucial decisions, welcome to OptumInsight.

We're one of the largest and fastest growing health information companies and the only organization in our industry with the information, technology and consulting expertise to solve the most significant challenges in health and human services. As a vital member of the UnitedHealth Group family, we serve customers in every segment of the health care field. This includes government agencies, pharmaceutical companies, hospitals and health delivery networks, insurance providers and, of course, the diverse business divisions of UnitedHealth Group.


Bring your talent to an industry leader with the information, technology, and consulting expertise to help transform health and human services. No matter what your role, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Requirements

 


Job Qualifications

 

Required qualifications:

 

-Bachelor's degree (preferably in Healthcare or relevant field)

-Certified Professional Coder

-5 or more years of experience giving presentations

-5 or more years of experience in ICD9 coding and training, reimbursement and health information technology

-ICD10 certification

-Three or more years of Field Sales Experience (Preferred) and/or Network Management, Contracting, Sales or Consulting experience

-Knowledge of Managed Care and Medicare programs and guidelines

-Ability to Develop Long Term Relationships

-Excellent Oral & Written Communication Skills (Experience giving group presentations)

-Good Work Ethic, Desire to Succeed, Self-Starter

-Strong business acumen and analytical skills

-Ability to formulate training materials designed to improve provider compliance

-Ability to use independent judgment, and to manage and impart confidential information

-Advanced proficiency in MS Office (Excel, PowerPoint and Word)

 

Preferred Qualifications: 

-HEDIS and CMS Stars Rating background preferred

-Master's degree

 


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.