1+ months

Manager Quality Assurance - Housecalls - Telecommute - 915413

Eden Prairie, MN 55344 Work Remotely
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  • Job Code
    915413

Under guidance of the Senior Manager or Associate Director of Quality Assurance, will be responsible for the oversight and daily activities of Quality Assurance Auditors. Will provide expert level coding quality auditing services to ensure compliance with Optum and CMS coding guidelines and accuracy of coding data reported. This position is also responsible for timely communication of identified quality issues. This role will work with Management and individual market leaders to ensure improvement in coding accuracy and various initiatives related to Coding Compliance are implemented.

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Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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Primary Responsibilities:

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  • Assists the Leadership team with oversight of the daily activities of the Clinical Performance Quality Assurance program
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  • Will perform second and/or third level quality assurance audits on vendor coding results, coder coding results and/or query language for internal Care Delivery coding teams, ensuring Quality Assurance Auditors and Senior Auditors are auditing in accordance with guidelines
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  • Responsible for the onboarding and training of new Quality Assurance Auditors and Senior Auditors
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  • Will lead assigned audit projects, provide direction/oversight for team of Quality Assurance Auditors, ensuring deadlines are met and escalate any areas of concern to Senior Management as necessary
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  • Review QA findings with Quality Assurance Auditors. Provide coaching and mentorship
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  • Acts as resource for coding questions and issues
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  • SME for Optum Coding Guidelines
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  • Ensure Optum Coding Guidelines and Compliance Policies are consistently applied in all processes
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  • Perform higher level compliance and other ad-hoc audits as needed
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  • Identify issues and analyze trends in coding and documentation. Provide input and valuable feedback to Senior Management on audit results in a timely manner
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  • Recommends process improvement and assists with implementation
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  • Collaborate with senior management to develop and revise training material based on QA results
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  • Provides support and assists all markets across Care Delivery with various coding/auditing initiatives as needed
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  • Develops relationships with Care Delivery Organizations and communicates guidelines and requirements to ensure correct coding and improved Provider documentation
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  • Cross-functional collaboration with multiple teams
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  • Perform all other related duties as assigned
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Youll 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.

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Required Qualifications:

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  • Coding Certification from AAPC or AHIMA (CPC, RHIT, CCS)
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  • 6+ years ICD-9/10 coding experience with strong attention to detail and high accuracy rate
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  • 5+ years CMS Risk Adjustment guidelines (HCC Coding)
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  • 4+ years in a coding auditor or team lead function, reviewing the work of other coders and providing feedback on results
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  • 1+ years Management experience
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  • Compliant Physician query experience
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  • Expert knowledge of ICD-10-CM guidelines
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  • Advanced knowledge of CMS-HCC model and guidelines
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  • Proficient experience working with multiple EMR and Coding Tool Software
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  • Self-motivated; ability to work independently in a fast-paced environment with minimal supervision and guidance
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  • Must be able to continuously meet the requirements for a telecommuter, i.e. live in a location that can receive a UnitedHealth Group approved high speed internet connection, have a secure designated office space to maintain PHI, meet or exceed all performance expectations
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • Associate degree or higher
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  • Inpatient coding experience
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  • CRC (Certified Risk Coder) in addition to required coding certification
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  • Excellent organizational, problem solving, and critical thinking skills
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  • Excellent verbal/written communication and interpersonal skills
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  • Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
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  • HEDIS/STARS knowledge
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  • Previous experience with WebEx or similar virtual meeting tools
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  • Previous experience using diagnosis coding data and trends to identify training opportunities
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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)
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"Colorado Residents Only: The salary/hourly range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Manager Quality Assurance, Housecalls, Telecommute, Work from Home, Coding Certification

Posted: 2021-03-10 Expires: 2021-05-08

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

Sponsored by:
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Manager Quality Assurance - Housecalls - Telecommute - 915413

UnitedHealth Group
Eden Prairie, MN 55344

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