Clinical Quality Analyst Coding

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Schedule : Monday through Friday from 8 : 30 am to 5 : 00 pmLocation :

2716 North Tenaya Way, Las Vegas, NV 89128The Clinical Quality Analyst Coding position supports IPA (Independent Provider Association) Providers with ongoing ICD 10 CM Coding Education relating to Medicare Advantage - Risk Adjustment CMS Documentation & Coding Guidelines by providing tools to allow for greater meaningful information exchange to allow providers to identify potential new clinical conditions early, reinforce self-care and prevention strategies, coordinate care, improve overall patient outcomes. This position will be responsible for effectively training clinical documentation skills for complete reporting of medical diagnoses to build an accurate health profile for each individual member.Primary Responsibilities :  Provide coding and documentation improvement education and training to IPA (Independent Provider Association) providers consistent with network goals, objectives and best practicesCollaborate with organizational leaders to identify emerging needs and generate solutionsServe as a Coding and Documentation resource to IPA Providers by performing concurrent reviews and targeted chart or HEDIS retrievals in provider officesCoding audit findings, industry updates and common medical documentation issues will be communicated to providers to ensure CMS and Optum compliance guidelinesWill perform coding reviews through Internal SystemParticipate in the development and onboarding of various programs for IPA providersTranslate concepts into practiceDevelop and implement effective analysis, research and evaluation of quality measures required for member demographic (Care of Older Adults (COA), Diagnostic and lab testing)Develop and maintain working relationships with our clinic partners, including providers and their support staff in personAbility to work with multiple internal and external partners at various levels of the organizationAdhere to project goals / milestones based on identified business needs / timelines, and obtain appropriate approvalsAdhere to established guidelines for formatting and templatesFunctions as part of a collaborative, high functioning coding education teamAbility to manage multiple tasks and projects, and forge solid interpersonal relationships within the department, with other departments and with external audiencesWorks with minimal guidance; seeks guidance on only the most complex tasksSolid aptitude for quickly troubleshooting and identifying the cause of questionable results within reports, provider documentation or charges submittedThis position requires an in-person presence in various provider offices routinelyAbility to move, lift and / or push 25+ poundsMust maintain flexibility and adjust working hours according to provider needsMust adhere to department standards for productivity and performanceMust adhere to HIPAA Confidentiality StandardsMust be available to attend monthly IPA Team meeting in personGenerally work is self-directed and not prescribedWorks with less structured, more complex issuesServes as a resource to othersWhat are the reasons to consider working for UnitedHealth Group?

Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include : Paid Time Off which you start to accrue with your first pay period plus 8 Paid HolidaysMedical Plan options along with participation in a Health Spending Account or a Health Saving accountDental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage401(k) Savings Plan, Employee Stock Purchase PlanEducation ReimbursementEmployee DiscountsEmployee Assistance ProgramEmployee Referral Bonus ProgramVoluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)More information can be downloaded at :  http : / / uhg.hr / uhgbenefitsYou'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 higherCoding Certification from AAPC or AHIMA professional coding association : (Example : CPC, CPC-H, CPC-P, RHIT, RHIA, CCS, CCS-P, CRC etc.) or RN / LPN with ability to obtain coding certification from AHIMA or AAPC within 12 months of hire5+ years of coding experience in assignment of ICD-10 diagnostic coding2+ years of experience with Medicare Advantage - Risk Adjustment CMS Documentation & Coding GuidelinesAdvanced level of proficiency in exemplary attention to detail and completeness with a thorough understanding of government rules and regulations and areas of scrutiny for potential areas of risk for fraud and abuse regarding coding and documentationPreferred QualificationsAssociates degree in related field, or equivalent experience directly related to the duties and responsibilities of this role2+ years of public speaking, talent development and / or education experienceExperience in developing and delivering coding education / training to non-coder professionalsDemonstrated leadership skills to include setting the example, motivating the team to be high performers and taking the initiative to achieve the outcomeProven advanced understanding of medical terminology, pharmacology, body systems and anatomy, physiology, and concepts of disease processesDemonstrated superior computer experience and ability to learn new computer applications quickly and independently, including : EMR(s), Microsoft Office Suite and other learning content development and publishing software programsDemonstrated ability to manage a significant workload and to work efficiently under pressure meeting established deadlines with limited supervisionDemonstrated solid analytical, problem-solving, planning, communication, documentation, and organizational skills with meticulous attention to detailDemonstrated ability to communicate in a clear and understandable manner, both orally and in writing; exercises independent judgment; influences and coordinate the efforts of others over whom one has no direct authorityDemonstrated ability to respond to provider requests by directing them to appropriate internal or external resourcesDemonstrated ability to abide by the Standards of Ethical Coding as set forth by AHIMA and AAPCProven customer service centered approach and alignment with UHG Cultural ValuesDriver's License and access to reliable transportationExperience creating reports related to quality improvement / performance outcomesExperience with quality measures such as HEDISExperience with Data RAP, Alliance, Facets systems and any other Electronic Medical Record Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

#RPO #RED