Clinical Quality Consultant - Telecommute
Company: UnitedHealth Group
Location: Miami
Posted on: June 25, 2022
Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that's
improving the lives of millions. Here, innovation isn't about
another gadget, it's about making health care data available
wherever and whenever people need it, safely and reliably. There's
no room for error. Join us and start doing your life's best
work.(sm) The Clinical Quality Consultant Nurse Practitioner (NP)
or Physician Assistant (PA) will apply clinical expertise and
knowledge of documentation guidelines to ensure the accuracy of
clinical documentation for Optum Home & Community and Care Delivery
programs. The Clinical Quality Consultant will collaborate with a
multidisciplinary team of physicians, advanced practice clinicians
and coding professionals as a member of the Clinical Documentation
Review team in Optum Clinical Performance. This position will
provide support to Optum clinicians and leadership to promote
excellence in clinical documentation. - This position is Monday -
Friday and reports to the Director, Clinical Documentation Review,
in Optum Clinical Performance You'll enjoy the flexibility to
telecommute* from anywhere within the U.S. as you take on some
tough challenges. Primary Responsibilities:
- Performs clinical chart reviews to ensure documentation
accuracy by applying established clinical criteria for the
diagnosing of medical conditions -
- Reviews reported diagnoses for clinical validation within the
visit note or medical record -
- Identifies documentation errors and opportunities for
documentation improvement and documents review findings in a
standardized form/audit tool -
- Collaborates with team members as part of the clinical review
process to promote a high level of accuracy and consistency of
results -
- Meets accuracy and productivity metrics to ensure team achieves
established departmental goals -
- Communicates with Optum leaders to address documentation issues
and trends - -
- Provides coaching to Optum clinicians to improve documentation
accuracy -
- Actively participates in all department meetings as scheduled
-
- Performs related duties, as required - 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. Required Qualifications: -
- Master of Science in Nursing or higher OR Certification by the
National Commission on Certification of Physician Assistants
(NCCPA) -
- Current Nurse Practitioner (NP) or Physician Assistant (PA)
licensure without restriction in state of residence -
- Nurse Practitioner national certification in Adult,
Adult-Geriatric, Family or Acute - -
- 5+ years of clinical experience as a Nurse Practitioner or
Physician Assistant -
- Solid clinical background in evidence-based medicine including
chronic disease management and prevention -
- Experience in ICD-10 coding and documentation requirements
-
- Ability to perform a comprehensive chart review of up to 50
medical records per day -
- Technical experience using different EMR systems -
- Proficiency in MS applications (Excel, Outlook, Teams,
PowerPoint & Word) -
- Ability to travel for on-site meetings 1-2 times per year
-
- Full COVID-19 vaccination is an essential requirement of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all federal, state and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to employment to
ensure compliance - Preferred Qualifications: -
- Coding certification from AAPC or AHIMA professional coding
association or additional coursework/experience in coding and/or
Risk Adjustment -
- Experience working with Medicare Advantage programs and CMS
Risk Adjustment model -
- Previous work experience in clinical documentation review or in
a clinical quality program -
- Experience developing and delivering clinical education and
training -
- Flexible and able to adapt to change based on departmental
needs -
- Excellent analytical and critical thinking skills - -
- Excellent verbal/written communication and interpersonal skills
-
- Ability to work independently and as part of a team in a
fast-paced environment - To protect the health and safety of our
workforce, patients and communities we serve, UnitedHealth Group
and its affiliate companies require all employees to disclose
COVID-19 vaccination status prior to beginning employment. In
addition, some roles and locations require full COVID-19
vaccination, including boosters, as an essential job function.
UnitedHealth Group adheres to all federal, state and local COVID-19
vaccination regulations as well as all client COVID-19 vaccination
requirements and will obtain the necessary information from
candidates prior to employment to ensure compliance. Candidates
must be able to perform all essential job functions with or without
reasonable accommodation. Failure to meet the vaccination
requirement may result in rescission of an employment offer or
termination of employment. - 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) - *All Telecommuters
will be required to adhere to UnitedHealth Group's Telecommuter
Policy. - Colorado, Connecticut or Nevada Residents Only: The
salary---range for Colorado residents is $82,100 to $146,900. The
salary---range for Connecticut/Nevada residents is $90,500 to
$161,600. Pay is based on several factors including but not limited
to education, work experience, certifications, etc. In addition to
your salary, UnitedHealth Group offers benefits such as, a
comprehensive benefits package, incentive and recognition programs,
equity stock purchase and 401k contribution (all benefits are
subject to eligibility requirements). No matter where or when you
begin a career with UnitedHealth Group, you'll find a far-reaching
choice of benefits and incentives. - 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. -
Keywords: UnitedHealth Group, Miami , Clinical Quality Consultant - Telecommute, Professions , Miami, Florida
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