Clinical Quality Coding Risk Adjustment Manager - Las Vegas, NV

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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)The Clinical Quality Coding Risk Adjustment Manager is responsible for the overall direction of our risk adjustment coding team of the OptumCare Local Care Delivery. Primary Responsibilities: Lead and influence others to achieve identified goals; identify, engage & lead individuals & team goals to identify solutions to complex operational issuesProgram leadership and support; improvement, development & implementation activities; oversight & monitoring. Work with others to develop, test and distribute accurate and meaningful care risk adjustment and quality performance dataActs as subject matter expert and monitors others' performance; willing consultant and resource for team and others; seeks to coach and mentorAssist Network Management Director and leadership with intervention of client issues pertaining to chart reviews, and research/resolution on coding projects as assignedImplement revisions to local coding Rules and Regulations that meet current CMS standardsDevelop/maintain coder new hire standards and coder training materials that meet those standards with collaboration of leadership and CDQI departmentCollaborate with Network Managers, Network Specialist, and leadership to best support the provider community with risk adjustment education and support Project Management: develop, document, implement and establish processes, interventions, materials and control systems to meet prioritized improvement goals & objectives:Actively managing projects so that delivery meets or exceeds requirements in a timely mannerFlexibly & enthusiastically support other projects, functions and duties as needed, e.g., committee support/facilitation, ad hoc project supportEnsure programs are in consistently aligned with CMS standards, and department culture & objectivesAttend seminars related to Coding and Compliance and education and other topicsAttend conference calls as necessary to provide information relating to coding and complianceInform leadership of trends identified through the review and validation processProvide related weekly, monthly and year end reports of attestations, quality audits, and concurrent review findingsOversee the quality analysis process of the Medicare Advantage Coders and 3rd party vendorsOther collaboration with UHC, HEDIS, RNS, CDQI, Clinical Quality team, and various departmentsDirect training as applicable and support staff as applicableOther 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.Required Qualifications:CPC and/or CCS certified (Certified Procedural Coder, Certified Coding Specialist)ICD-10 Certified5+ years of supervisory or management experience4+ years of progressively responsible experience in a coding environmentExperience in medical coding and/or claims researchFull COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliancePreferred Qualifications:HCC/RAF experienceExperience building management reports in ExcelProven project management experienceWorking knowledge of HEDIS/StarsTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination 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 the health system 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)Nevada Residents Only: The salary range for Nevada residents is $87,900 to $156,900. 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.OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.For more information on our Internal Job Posting Policy, click here.Diversity creates a healthier atmosphere: 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.Job Keywords: Clinical Quality Coding Risk Adjustment Manager, Coding Manager, RNS, CDQI, Clinical Quality, Las Vegas, NV, NevadaBrand: Optum Care DeliveryJob ID: 2026316Employment Type: Full-timeJob Area: Clinical