Sr. Practice Performance Advisor - Telecommute job at UnitedHealth Group, San Antonio

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
 
The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This specialist role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you'll use your expertise and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities:

• Functioning independently with outreach to providers to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage Members, Medicaid and ACA Members
• Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources
• Inbound and outbound calling to connect virtually in order to establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and hospitals
• Manage end-to-end Risk and Quality Client Programs such as Healthcare Patient Assessment Form on ensuring correct delivery of data/forms to the correct providers, and the return of the data to coding ops, ensuring accurate payments are occurring for each provider based on client contract
• Consult with provider groups on gaps in documentation and coding
• Provide feedback on EMR/EHR systems where it is causing issues in meeting CMS standards of documentation and coding
• Partner with a multi-disciplinary team to implement prospective programs as directed by Market Consultation leadership
• Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding 
• Supports the providers by ensuring documentation supports the submission of relevant ICD -10 codes and CPT2 procedural information in accordance with national coding guidelines and appropriate reimbursement requirements 
• Delivers diagnosis coding tools to providers 
• Provides measurable, actionable solutions to providers that will result in improved accuracy for documentation and coding practices 
• Collaborates with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts

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:

• High school diploma/GED or above
• 2+ years of experience within the Healthcare Field
• Understanding of Medicare Advantage, Medicaid and ACA programs
• Proficient in MS Office (Excel (Pivot tables, excel functions), PowerPoint and Word)
• Ability to identify confidentiality and its requirements (HIPAA)

Preferred Qualifications:

• 2+ years of Customer Service Representative (CSR) experience OR 1+ years of experience in an office setting or call center setting
• Experience with medical terminology
• Knowledge of ICD10, HEDIS and Stars
• Knowledge of CMS-HCC Risk Adjustment
• Knowledge of provider office workflow
• Ability to work independently toward individual and team metrics
• Ability to interact and verbally communicate effectively with provider offices and all levels of personnel in a professional, courteous, and effective manner with excellent customer service skills
• Demonstrated organizational and prioritization skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

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)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $21.68 to $38.56. The hourly range for Connecticut / Nevada residents is $23.94 to $42.40. 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 Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/AffirmativSe 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 bylower 48 law.

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