Serving millions of Medicare and Medicaid patients, Optum is the nation's largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family of businesses. We're also the career home for Nurse Practitioners or Physician Assistants who are eager to bring compassion and passion, energy and focus to their work every day. Join us and you'll discover a chance to build meaningful relationships with the patients, their families and the health care providers who are responsible for their care. In this role, you will work directly with the Clinical Education team, Network Managers and Medical Directors of OptumCare UT Networks. You will cultivate relationships with over 1100 network providers and facilitate initial as well as ongoing training to positively impact HEDIS, STAR and RAF scoring. Primary Responsibilities:
- Provide education to new and existing network healthcare providers and staff regarding the RAF and STAR measures utilizing approved learning tools
- Communicate with healthcare providers and staff regarding questions and/or concerns related to Coding, Documentation and Quality Measures, including training back office staff, administrative staff and coding staff of network clinics in the importance of risk adjustment coding, HCC recapture and the administration of Optum programs to facilitate the achievement of goals related to these topics
- The successful candidate will be expected to work closely and cooperatively with Optum Coding Educators, Network Managers and others on the Clinical Education team to improve coding, documentation and HEDIS/STAR goal achievement for network providers and clinics
- Clinician Educator is a Physician Assistant – Certified or an Advanced Practice Nurse who has completed the course of study of said title and obtained the licensure requirements for the state of Utah
- Conduct educational training in various venues, including clinic during and occasionally before and after business hours, as well as participating and presenting during RAF dinners and other events as scheduled
- Trainings will range from provider shadowing, 1 on 1 sessions to large group settings, and will utilize Optum-provided materials
- Conduct chart reviews and provide feedback for network healthcare providers
- Report directly to the senior clinician educator as well as the medical director of OptumCare UT for updates and additional directives as needed.
- Provide direct patient care on a smaller scale with occasional coverage of Optum Community centers to provide Medicare advantage annual wellness exams and physicals, so candidate will be required to maintain clinical skills as well as licensure requirements
- Provide clinical insight and perspective in a consultative fashion for the development of other related programs including: Provider engagement, Data and Analytics programs, work-flow and operations, technology development and others
- Approximately 70% daily travel within market
- Interface professionally with physicians / medical group staff developing credibility as well as maintain strong positive customer relationships and serve as subject matter expert and mentor
- Provide regular and effective communication with internal and external parties including: physicians, members, key decision-makers, nursing facilities, OptumCare staff and other provider groups
- Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/ issues
- Function independently and responsibly with minimal need for supervision. Demonstrate initiative in achieving individual, team and organizational goals and objectives
- Active unrestricted NP or PA-C License in the State where this position is based, or ability to obtain
- NP Certification in Adult, Family or Geriatrics or PA Certification or ability to obtain
- 3 + years of clinical practice experience
- Basic technical proficiency in the use of computer programs for medical records or Internet search for clinical practice
- Valid driver’s license and required liability insurance for personal vehicle
- Ability to travel within assigned geographic area up to 70% of the time
- Familiarity with ICD-10 coding and CPT coding, and the ability and willingness to develop expertise in these subjects
- Ability to work independently when necessary and strong ability to work effectively as a team member
- Proficiency Microsoft Excel, Word, PowerPoint, Outlook
- Physician network development and / or provider relationship experience
- 2+ years of experience working in a managed care health plan environment, and/or experience working with geriatric or Medicare patient population
- HEDIS, Coding, Risk Adjustment and/or educational experience
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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)
**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: Clinician Educator