There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) Must be able to travel to San Antonio, TX during the work week for approximately 4 to 6 weeks of training.The Clinical Coding Nurse Consultant assists in the development of operational framework focused on scalable and repeatable best practices as it relates to Risk Adjustment both within the DataRAP Department and at the Market level. This position supports and aligns planning to ensure the key strategic rationale for DataRAP is delivered and the associated revenues and cost savings targets are realized. Responsible for working closely with leaders in all markets to ensure Enterprise initiatives related to DataRAP (Risk Adjustment) are implemented and goals are met. The Clinical Coding Nurse Consultant is embedded in all Markets to provide support and education to all market leaders, Providers and Clinic Staff. This position identifies, develops and implements simplification and automation to improve the Primary Care Provider (PCP), the Market and ultimately, the member experience.
Required Qualifications:Undergraduate degree or equivalent experience Bachelor's Degree in Nursing required (Associate's Degree or Nursing Diploma from accredited nursing school with 2 or more years of additional experience may be substituted in lieu of a Bachelor's degree) and current Florida RN license in good standing CPC Certification or proof that certification has been obtained within 9 months of hire from the American Academy of Professional Coders 4+ years of General Clinical experience 2+ years of clinical coding experience with strong attention to detail and a high level of accuracy Knowledge of CMS-HCC model and guidelines along with ICD 10 guidelines Ability to speak and provide presentations and education to small and large groups alike Ability to work a flexible work schedule and travel to markets that may require overnight stays Effectively communicates complex ideas clearly and concisely to internal and external customers alike Able to create, build and maintain relationships in order to improve performance and establish trust and maintain credibility throughout the organization Demonstrates effective interpersonal, influence, collaboration and listening skills to address complex situations or issues with a high degree of integrity Must possess excellent time management, organizational and prioritization skills and ability to balance multiple priorities and make changes to work as the business needs dictate Moderate to advanced knowledge of and use of Microsoft Office Products (inclusive of both Excel and PowerPoint)Preferred Qualifications:Bachelor's Degree 2+ years coding experience Quality Assurance auditing experience Chart Review ExperienceIf the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) 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. Registered Nurse, RN, Clinical Coding, CPC, Ft Myers, FL, Florida
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.