Health Care Advocate - Telecommute in Oahu, HI - Full-time / Part-time

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)
Primary Responsibilities:


Functioning independently, travel across assigned territory to meet with providers to discuss Optum 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 coding, documentation and quality training and resources

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

Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and hospitals

Develop comprehensive, provider-specific plans to increase their RAF performance and improve their coding specificity

Provide training to provider groups on Medicare Advantage, quality measures (HEDIS) and risk adjustment

Coordinate large and small group training sessions in collaboration with the Optum Coding Trainers and Clinical staff

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

Coordinate risk adjustment chart reviews with capitated or risk share providers

Work with providers to break down barriers for chart review participation

Facilitate and educate providers on RADV, and data validation audits

Required Qualifications:
 

3 or more years of network management, pharmaceutical sales, coding, or healthcare consulting experience
Ability to develop long term relationships
Good work ethic and ability to work independently
Excellent oral and written communication skills
Strong business acumen and analytical skills
Project management skills
Proficiency in Microsoft Word and Excel
Ability to travel within assigned territory (day trips) up to 60% of the time
Must live within a commutable distance of Honolulu, HI
 
Preferred Qualifications:


Bachelor's Degree
5 or more years of network management, pharmaceutical sales, coding, or healthcare consulting experience
Knowledge of managed care, HEDIS and Medicare programs
Experience conducting presentations
Robust coding expertise and/or a CPC
ICD10 Certification
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, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

 
 
Keywords: Network Management, Pharmaceutical Sales, Coding, CPC, Healthcare consulting, HEDIS, CPC, ICD10, Sales, Managed Care, Honolulu, Oahu, HI, Hawaii