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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Medical and Clinical Operations



Approximate Salary:

Not Specified

Position Type:

Full Time

Manager, Clinical Coding Quality - Optum - Local Telecommute within Las Vegas, NV

UHG - Las Vegas, Nevada

Posted: 11/17/2018

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)


The Manager, Clinical Coding Quality, leads the Coding team to support business goals and ensures team compliance with Optum guidelines and regulatory and state statutes.  Evaluates process outcomes and designs interventions for improvement across multiple lines of business.  Interacts & collaborates with cross-functional teams / departments.  Strong attention to detail, ability to perform in a deadline driven environment.   Ability to maintain professionalism and a positive service attitude at all times.   Ability to manage and impart confidential information to staff.   Ability to analyze facts and exercise sound judgment when arriving at conclusions.  Ability to effectively report deficiencies with a recommended solution in oral and / or written form.  Requires excellent verbal & written communication and interpersonal skills.
If you are located in Nevada, you will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
  • Responsible for audit outcomes and response to health plans
  • Works with other businesses to identify any potential opportunities for accurate and complete submissions
  • Evaluates processes for new programs
  • Design programs in coordination with the health plan
  • Attends meetings with various health plans to evaluate performance, recommend improvement, etc. to expand business opportunities
  • Partner with Network Management in onboarding new clients
  • Manages and oversees the team on quality and productivity (overall performance, including identification of strengths and weaknesses, individual action plans, mentoring and delivering valued one-on-one feedback to individuals on the team)
  • Acts as the direct line resource to the team for questions and issues
  • Supports and executes quality and productivity goals
  • Reviews weekly team performance reports to meet business goals
  • Adjusts workload and team assignments as necessary to ensure accuracy and to meet production goals
  • Coaches & manages employees in performance improvement
  • Participates in the interviewing and onboarding of new staff
  • Coordinates and delivers onboarding and orientation of new hires and contractors, when necessary
  • Provides feedback and completes annual employee performance reviews
  • Coordinates employee schedules, including PTO requests to ensure adequate coverage
  • Reviews / approves time sheets for employees and contractors
  • Promotes morale by clearly communicating goals, standards and needs of the department and organization
  • Fosters an environment of teamwork and service excellence within the department
  • Actively participates in the documentation and coding training of new and existing providers
  • Under the direction of management, organizes and oversees the quality review process of the field providers
  • Collaborates with Medical Directors and Market Leadership to strengthen documentation for identified deficiencies and conducts focused training/education to market providers in effort to strengthen documentation and coding

Required Qualifications:
  • Associate or Bachelor’s degree in healthcare information management, or related field, or equivalent experience preferred
  • Coding Certification from AAPC or AHIMA professional coding association (CPC, RHIT, RHIA, CCS)
  • 5+ years of coding experience with ICD diagnosis codes
  • 3+ years of experience with Risk Adjustment and HCC Model coding 
  • 5+ years of experience in an auditor role, such as vendor QA, or coder QA, providing feedback of audit results
  • 1+ years of management experience
  • Working knowledge of CMS payment cycle and sweep process
  • Demonstrated ability to work independently and manage work efficiently
  • Experience educating / mentoring / coaching others to improve results in clinical coding
  • Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
Preferred Qualifications:
  • Prior experience as a clinical documentation improvement specialist or inpatient hospital experience
  • Working knowledge of CPT / Evaluation and Management guidelines, relevant to job function

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)


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


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: Risk Adjustment Manager, Risk Adjustment Supervisor, Clinical Documentation Manager, Quality Improvement Supervisor, Quality Assurance, RHIT, CCS, CPC, AAPC, AHIMA

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