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Healthcare Advocate - Telecommute in Brooklyn, Bronx or Queens

UnitedHealth Group


Location:
Brooklyn, NY
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1791792
Apply on the Company Site
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Job Details


Healthcare Advocate - Telecommute in Brooklyn, Bronx or Queens(Job Number:732101)
Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

 

The Healthcare Advocate is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program/product implementation. This includes enterprise-wide Clinically Integrated Network teams that focus on specific clinical area Lines of Service (e.g., Cardiology, Women's Health, Oncology, etc.) to improve the quality and affordability through improvements in appropriateness and effectiveness. Network Program Consultants may perform network analysis and strategy development and implementation; obtain data, verify validity of data, and analyze data as required, and analyze network availability and access. Other responsibilities may also include making recommendations regarding use, expansion, selection of networks for various products based on that analysis.

 

This will be a telecommute position, but does require being in the field up to 4 days per week. New York territories including but limited to Brooklyn, Bronx & Queens as needed.

 

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
  • Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources
  • Educate providers on how to improve their Risk Adjustment Factor (RAF) scores, which measure their patients' health status
  • 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
  • Provide training to provider groups on Medicare Advantage, quality measures (HEDIS) and risk adjustment
  • Coordinate large and small group training sessions in collaboration with the Optum Coding Trainers and Clinical staff
  • Collaborate with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment education efforts
  • Manage end-to-end Healthcare Patient Assessment Form program 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
  • CRC, CPC coding certification preferred

Job Network Program Mgmt
Primary Location US-NY-Brooklyn
Other Location US-NY-Bronx, US-NY-Queens
Organization RQNS Ops
Schedule Full-time
Number of Openings 3
Apply on the Company Site

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.

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