RN Provider Educator for WellMed SIGN ON BONUS

$1500.00 Sign-on Bonus

WellMed provides concierge-level medical care and service for seniors, delivered by physicians and clinic staff that understand and care about the patient's health.  WellMed's proactive approach focuses on prevention and the complete coordination of care for patients.  WellMed is now part of the Optum  division under the greater UnitedHealth Group umbrella.

Do you have persuasive communication skills and a passion for quality senior healthcare?  Transforming Medicare healthcare delivery and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work SM

In this position you will use your clinical skills to improve the quality of Medicare healthcare delivery.  You will use your powers of persuasion to educate providers about diagnoses and procedures.  You will travel 30% of the time to  WellMed provider offices where you will perform quality audits for provider education purposes. 

Essential Job Functions

• Performs quality audits for providers participating with WellMed Medical Management risk adjustment model


• Ensures compliance with ICD-9 CM guidelines and CMS Risk Adjustment Data Validation requirements.


• Reports outcomes to the Contracted Physicians Management Department throughout the year.


• Collaborates with the Chief Education Development Officer / Physician Education Development team, Management Team, Contracted Physicians Management Department, and Provider Relations Team to report educational needs identified or requested.


• Creates, maintains, organizes internal and external educational tools as needed as well as updating existing tools with Physician Education Development Team, Contracted Physicians Management Department , and Provider Relations Team


• Audits work of Clinical Coding Nurses, Medical Coding Analysts, and Processing Coordinator and provides feedback to supervisor/manager.


• Provides education to include on-boarding and re-education needs.


• Analyzes data along with Clinical Process Quality Manager to identify deficiencies, measure current state, suggest improvements, implement change, re-measure outcomes, and refine as related to total process.


• Creates and writes policies in procedures in collaboration with Clinical Process Quality Manager.


• Communicates with I.T. Department regarding defects in the reporting system or database, tracks through to completion.


• Monitors Team Discussion Board and answers questions after thorough research.

• Posts coding updates to the Team Discussion Board for continued education of all current staff as related to coding quality.


• Performs annual HEDIS chart reviews as determined by Clinical Process Quality Manager or contracted plan.

• Current unrestricted RN license in the state of Texas


• CPC certification or willing to obtain within 9 months from the American Academy of Professional Coders.


• 2+ years of varied clinical experience (preferably in chart review/audits, quality or coding).


• Knowledge of CMS-HCC model and guidelines


• Knowledge of ICD-9 CM and guidelines


• Basic computer and data skills including Access, Excel and Word


• Ability to interact with multiple departments and outside physician groups


• Ability to speak and provide presentations and education to small and large groups alike


• Effective verbal and written communication skills with ability to communicate complicated medical and coding information.


• Ability and willingness to travel 30% of the time to  provider offices

Preferred Education, Experience & Skills

• Bachelor's degree preferred


• Strong working knowledge of ICD-9 coding


• Quality assurance auditing experience

WellMed is a healthcare delivery system serving more than 90,000 patients, primarily Medicare eligible seniors, in Texas and Florida through primary care clinics, multi-specialty clinics, and contracted medical management services.  Headquartered in San Antonio, Texas, WellMed is an industry leader in medical risk management, highly effective disease management and chronic care programs, healthcare delivery services and more.

Our focus and mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness.  We are innovators in preventative healthcare, striving to change the face of healthcare delivery for seniors.  Our providers and support staff are selected for their dedication to the senior population and focus on preventative, proactive patient care.

WellMed is now part of the OptumHealth division under the greater UnitedHealth Group umbrella.

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.

Key Words: RN, ICD-9; Coding; AAPC; chart review, registered nurse, CPC, san antonio, tx, educator, provider education, sign-on bonus