Vacancy caducado!
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:The Manager and Clinical Consultant, Clinical Documentation Integrity in Optum Advisory, Finance & Operations serves as a clinical consultant and subject matter expert (SME) for engagements with healthcare provider clients across a range of projects, primarily focused on ambulatory professional clinical documentation integrity across: 1) provider education and engagement in clinical documentation concepts focused on fee-for-service (E/M, ICD-10-CM / PCS, CPT, HCPCS) and clinical risk adjustment (HCC) and 2) ambulatory CDI program development, implementation and/or optimization. Additional clinical revenue cycle projects may focus across acute care CDI, coding optimization (profee, outpatient, and inpatient), and/or organizational structure redesign, optimization, and centralization. While not a principal focus of this role, project efforts may require collaboration with key teams typically outside of the revenue cycle, such as care management, utilization review, population health, and other key areas as needed. Key responsibilities of the Manager and Clinical Consultant, Ambulatory CDI role will include:
Serves as clinical consultant and subject matter expert for clinical engagements, with emphasis on ambulatory clinical documentation integrity
Demonstrates sufficient executive presence to lead presentations, including key client executive leadership sessions and provider documentation education sessions (individual and group) both in-person and live, remote
Assists consulting team in accurately diagnosing client clinical revenue cycle improvement opportunities and issues and determines the appropriate solutions that will lead the client to achieve best practice
Identifies needed data/information for the engagement and provides subject matter expertise as need in conducting appropriate analyses (e.g., provider outlier analytics, E/M analytics, HCC analytics)
Prepares customized client recommendations to realize improvement opportunities identified based on industry best practices and emerging ‘best-in-class’ approaches and facilitates implementation of recommendations
Supports presentation of clinical engagement deliverables to applicable stakeholders (e.g. diagnostic findings and recommendations, chart review findings, clinical documentation integrity improvement opportunities)
Conducts clinical analytics, such as professional, outpatient, and/or inpatient chart reviews and/or oversees chart review efforts conducted by third-party partners, providing guidance and quality assurance
Builds consensus among client stakeholders who play a critical key role in the health system’s ability to successfully implement the recommended strategies and tactics
Communicates effectively and accurately in writing and verbally to prospects, members and other staff
Demonstrates strong relationship management skills and ability to handle challenging interpersonal situations
Cultivates the client's perception of Optum as a trusted partner and strategic advisor (e.g., build credibility, demonstrate full understanding of their business, leverage other resources within OptumInsight)
Drives high levels of client satisfaction by driving results that meet or exceed the client's expectations
Ensures engagement quality through running to criticism with both team members and clients alike, regularly seeking proactive feedback and adjusting course as needed based on feedback provided
Applies knowledge of change management principles to drive implementation of engagement objectives
Leverages project documents and deliverables to provide re-use/transferability for other engagements (e.g., de-identifying content, cataloguing deliverables, storing documents in appropriate shared folders)
Identifies lessons learned and communicate to appropriate stakeholders across both internal team and client, as appropriate
Provides subject matter expertise to contribute to new product development as well as the enhancement of existing solutions
Leverages and contributes to the applicable knowledge repositories (e.g., Microsoft Teams, SharePoint, analysis tools, project toolkits)
Contributes to practice-level initiatives, including business development and thought leadership, beyond client project work, including preparation for and participation in clinical revenue cycle business development meetings, demonstration of solutions, and overall pipeline development / strategy
Serves as a clinical subject matter expert for business development activities, participating in internal and client facing meetings as needed
Stays current on important issues in the healthcare industry and maintains active participation in relevant professional organizations (e.g. ACDIS, MGMA, AHIMA), sharing key trends and lessons learned back with broader team
Shares professional and domain knowledge with peers and colleagues to build overall organization capabilities and expertise
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.Required Qualifications:
U.S. Registered Nurse (RN) or Bachelor of Science in Nursing (BSN)
Certified Clinical Documentation Specialist-Outpatient (CCDS-O) OR Certified Risk Coder (CRC)
3+ years of ambulatory clinical documentation integrity focused experience within a healthcare provider setting
Experience facilitating the formal exchange and delivery of information within all levels in a provider based, client organization, including, but not limited to: primary care physicians, surgeons, anesthesiologists, hospital executives, and other professional and ancillary staff
Exceptional subject matter knowledge of ambulatory clinical documentation
Willingness to travel to client onsites as needed (up to 70%)
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $101,200 to $184,000 per year. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers 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
Vacancy caducado!