This position identifies, develops and implements simplification and automation to improve HCC/ RAF/ HEDIS and other key performance initiatives Coordinates performance improvement programs related to clinical coding as well as clinical and administrative workflows and business processes. Works with office staff and management to implement new processes and train staff on methodology Oversees and works to grow population health initiatives and performance initiatives. Supports initiatives design... more details
Careers at Unity Health Network, part of the Optum and UnitedHealth Group family of businesses. Unity Health Network is the largest independent physician network in Northeast Ohio. Our infrastructure enables us to provide extensive primary care services and diverse specialty care offerings while removing non-medical business functions from our clinical staff, allowing them to concentrate on care delivery. Our team is growing, and we are looking for more health care professionals who want to be part of an organization that is driven by excellence. You can be part of a dedicated health care team that provides high quality and timely patient-centered services. In return, we will provide you with competitive opportunities that are driven to change the future of health care delivery and your career.
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 to start Caring. Connecting. Growing together.
Coordinates the development of operational framework focused on scalable and repeatable best practices as it relates to Risk Adjustment and Clinical Quality Metrics. Works to identify and improve quality, risk, and affordability initiatives. May visit physician practices as needed.
Primary Responsibilities:
- This position identifies, develops and implements simplification and automation to improve HCC/RAF/HEDIS and other key performance initiatives
- Coordinates performance improvement programs related to clinical coding as well as clinical and administrative workflows and business processes. Works with office staff and management to implement new processes and train staff on methodology
- Oversees and works to grow population health initiatives and performance initiatives. Supports initiatives designed to reduce avoidable hospital visits, avoidable emergency room visits and readmissions
- Ensures effective communication with physicians and staff members to enhance the successand support growth of each practice and attainment of quality and performance metrics
- Monitors data, completes data analysis and conducts audits as indicated. Reports status of quality, risk, and affordability programs to appropriate team members, senior management and physicians
- Population Specific Competency: The incumbent will have the ability to effectively interact with populations of the patient (and his or her representative) with a sensitivity to the communication needs (other language, deaf or blind) and with an understanding of their needs for self-respect and dignity
- Commitment to Service Excellence: Committed to providing exceptional service to patients, visitors and internal/external contacts. Strives to provide the highest level of patient satisfaction with each interaction. Committed to treating co-workers with respect and dignity. Ensures a consistently positive experience for all patients, employees and visitors
- Attendance and Punctuality: Adheres to the attendance policy and will make every effort to consistently be punctual when reporting to work and during daily activities
Note: The above stated duties are intended to outline those functions typically performed by the incumbent in this position. This description of duties is not intended to be all-inclusive nor to limit the discretionary authority of supervisors to assign additional tasks of a similar nature or level ofresponsibility.
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.
Required Qualifications:
- Graduate of an accredited school of nursing with a current State of Ohio nursing license
- 2+ years of clinical nursing experience
- Ability to use independent judgment and access quality metrics objectively andprofessionally
- Ability to effectively communicate verbally and in writing with all physicians and staff members, at all levels of the organization
- Experience with Microsoft office products
Preferred Qualifications:
- Certified Risk Adjustment Coder (CRC) certification or proof that certification has been obtained within 6 months of start date from the American Academy of Professional Coders
- Excel experience
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment
