Healthcare Advocate Field Based in Springfield MO

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

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's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. 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


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 relevant field) or equivalent work experience
  • Previous experience in Risk Adjustment and HEDIS/Stars
  • Knowledge of ICD10, HEDIS and Stars
  • Advanced proficiency in MS Office (Excel (Pivot tables, excel functions), PowerPoint and Word)
  • Ability to work effectively with common office software, coding software, EMR and abstracting systems


Preferred Qualifications:
  • Master's degree Certified Professional Coder / CPC-A; equivalent certifications acceptable
  • 4+ years of clinic or hospital experience and/or managed care experience
  • 1+ years of coding performed at a health care facility
  • CRC certification
  • Nursing background i.e. LPN, RN, NP
  • Knowledge of EMR for recording patient visits
  • Previous experience in management position in a physician practice
  • Knowledge of billing/claims submission and other related actions


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination 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)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only : The salary range for Colorado residents is $64,800 to $116,000. The salary range for Connecticut/Nevada residents is $71,400 to $127,400. 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

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: HEDIS, STARS, CPC, CRC, Sales, Provider Relations, Risk Adjustment, field based, Eau Claire WI, Wisconsin

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