The Clinical Coding analyst assists in the development of operational framework focused on scalable and repeatable best practices as it relates to Risk Adjustment. This position supports and aligns planning to ensure the key strategic activities aimed at HCC/RAF management for Clinically Integrated Network is delivered and executed at the clinic level. Responsible for working closely with leaders and other coders ensure Clinically Integrated Network initiatives are implemented and goals are met. The Clinical Coding analyst works centrally to support multiple clinics to identify and provide actionable support and education to all market leaders, Providers and clinic staff. This position identifies, develops and implements simplification and automation to improve Clinically Integrated Network initiatives. The Clinical Coding analyst will also act as a facilitator, leader, mentor and change agent.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Educate practitioners/clinical staff and provide ongoing clinical guidance related to the Risk Adjustment process
- Work collaboratively with Clinically Integrated Network leadership in the development of program success metrics and ongoing performance metrics
- Provide strong leadership and judgment; effectively build and deepen relationships across the marketplace
- Create a team-oriented work climate that enables professional development and encourages creative solutions and strategies, establishes collaboration and emphasizes quality and cost
- Provides educational tools which may include presentations as assigned by management
- Perform Clinical Chart Audits on an ongoing basis
- Perform Quality Audits on an ongoing basis
- Maintain compliance with AAPC coding standards and CMS Risk Adjustment guidelines
- Incorporates principles of adult learning in the planning, implementation, and evaluation of education programs using a variety of strategic tools
- Assists with orientation of new staff to the organization
- Develops and coordinates education plans related to initial and ongoing competency validation
- Plans, prepares and maintains materials for use in educational programs for accuracy and relevance to the target audience
- Supports staff development with educational activities (which include remediation, certification, mentoring, NCQA requirements, product roll-outs, etc.)
- Evaluates the effectiveness of educational programming
- Participates in committees, task forces, projects for areas of coverage within the CIN team
- Facilitates teambuilding and leadership development
- Serves as a role model to promote excellence and safety
- Maintains required educational and/or clinical competencies
- Seek opportunities to develop staff in various roles
- Integrates ethical principles in all aspects of practice
- Serves as a role model for education and professional coding practice
- Performs other duties as assigned
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Bachelor's Degree required (8 or more years of additional experience beyond the required years of experience may be substituted in lieu of a bachelor's degree)
- CPC certification required or that CPC certification will be obtained within 9 months of hire from the American Academy of Professional Coders
- Work Experience: 5 years of General Clinical experience
- 2 years of clinical coding experience with strong attention to detail and a high level of accuracy
- Requires full range of body motion including handling and lifting, manual and finger dexterity and eye-hand coordination. Involves standing and walking. Occasionally lifts and carries items weighing up to 50 pounds. Requires normal visual acuity and hearing. Requires driving between multiple clinic locations
- You will be required to adhere to UnitedHealth Group’s US Telecommuting Policy
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors., WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for 550,000+ older adults with over 16,000 doctors’ offices in Texas and Florida through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
Colorado Residents Only: The hourly range for Colorado residents is $17.12 to $30.34. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.
Job Keywords: Certified Coder, CPC, HCC, Risk Adjustment, DataRap, Outpatient Coding, Texas, Arizona, Nevada, Florida, California