Telecommute Healthcare Advocate

Company: UnitedHealth Group
Location: Bowling Green
Posted on: September 3, 2024

Job Description:

If you reside within Western, KY you will have the flexibility to telecommute* as you take on some tough challenges.



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. Will be out in the field 80% of time in defined territory with rare occasion of overnight travel
Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources
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
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
Assists providers in understanding the Medicare quality program as well as CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
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
Provides ICD10 - HCC coding training to providers and appropriate office staff as needed
Develops and presents coding presentations and training to large and small groups of clinicians, practice managers and certified coders developing training to fit specific provider's needs
Develops and delivers diagnosis coding tools to providers
Trains physicians and other staff regarding documentation, billing and coding and provides feedback to physicians regarding documentation practices
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
Assist in collecting charts where necessary for analysis



This position requires travel up to 75% within the state. Relocation is not provided for this position.

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:


Bachelor's degree (preferably in Healthcare or related field) or equivalent work experience
Proficiency in MS Office (Excel (Pivot tables, excel functions), PowerPoint and Word)
Must be able to work effectively with common office software, coding software, EMR and abstracting systems
Ability to communicate and present to multiple stakeholders using various types of media
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Proven ability to effectively engage, manage and maintain relationships with physicians/hospitals/health systems/clinical and non-clinical personnel
Ability to travel within state up to 75% of the time to client locations
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Keywords: UnitedHealth Group, Bowling Green , Telecommute Healthcare Advocate, Healthcare , Bowling Green, Kentucky