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)
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.
Positions in this function 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. Customers served: 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
- Monitor and maintain 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.
$5,000 Sign-on bonus for External Candidates!
Required Qualifications:
- Bachelor’s of Science in Nursing or related field (8+ years of experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree)
- Current Registered Nurse (RN) licensure
- 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 clinical RN experience with 3+ years of ICD-9 diagnostic coding and supervisory experience
- 1+ years of effectively reporting data, making fact based decisions and recommendations in oral and/or written form
- Solid knowledge of ICD - 9 coding processes with excellent analytical and data mining skills
Preferred Qualifications:
- Master’s of Science in Nursing or related field
- 4+ years of medical coding operations management experience
- Ability to analyze facts and exercise sound judgment when arriving at conclusions
- Ability to effectively manage projects, plan and implement programs and evaluate outcomes
- Ability and willingness to travel a minimum of 30%, (locally and non - locally) as determined by business need
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.
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
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.
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.