Manager Clinical Data Operations - McAllen RGV TX

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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

The Manager, Clinical Data Operations manages plans and organizes the DataRAP department staff and operations to ensure that the DataRAP processes for record reviews are conducted in a timely manner to meet company and regulatory standards. The customers served are DataRAP staff, providers, medical group administrators and business associates.

Primary Responsibilities:
  • Provides Day-to-day oversight of multiple market operations for the DataRAP department and staff to ensure DataRAP processes are completed timely to meet company and regulatory standards
  • Develops new and revises existing DataRAP medical record review processes and resource/reference tools
  • Coordinates educational training sessions for market Primary Care Physicians and their staff to ensure compliance with DataRAP processes
  • Maintains monthly reporting to network management, physician business managers and clinic staff to assist PCP's remain compliant with DataRAP processes
  • Monitors staff compliance with DataRAP policies and procedures to ensure quality outcomes for the department
  • Monitors and maintains staff productivity and coordinates all training for new and existing employees
  • Assists other managers and supervisors in the hiring of staff for all markets and assures adequate staffing is in place to meet market demands
  • Provides employee coaching, counseling and evaluation of performance through periodic and annual reviews
  • Performs all other related 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.

Required Qualifications:
  • Bachelor of Science in Nursing or related field, or equivalent experience
  • Current Registered Nurse (RN) licensure - Unrestricted Texas or Compact
  • CPC certification or proof that certification has been obtained within nine months of hire date from the American Academy of Professional Coders
  • 5+ years of experience as a clinical RN
  • 3+ years of ICD-9 diagnostic coding and supervisory experience
  • Ability to effectively manage projects, plan and implement programs and evaluate outcomes
  • Ability to effectively report data, facts and recommendations in oral and/or written form
  • Ability to analyze facts and exercise sound judgment when arriving at conclusions
  • Ability to effectively manage and direct various levels of staff
  • Ability and willingness to travel a minimum of 30%, (locally and non-locally) as determined by business need
  • You will be asked to perform this role in an office setting or other company location

Preferred Qualifications:
  • Master of Science in Nursing or related field
  • 4+ years of experience in medical coding operations management

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors 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)

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.

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: Manager clinical data operations, nursing, RN, ICD-9, medical coding, McAllen, TX, Texas

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