RN Clinical Educator - ProHealth Physicians - Farmington, CT
Company: UnitedHealth Group
Location: New Britain
Posted on: June 16, 2022
Job Description:
* $1,000 SIGN ON BONUS FOR ALL NEW EXTERNAL HIRES *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 Nurse
Quality/Clinical Educator (Risk Adjustment) will be responsible for
the day to day management of Quality programs, initiatives, and
reporting as well as for Risk Adjustment activities for Optum Care
Network of Connecticut -providers. The existing quality programs at
Optum Care CT IPA are recognized as the best in the state by many
business partners. In the Quality role, you would provide support
to the teams implementing and reporting on these programs. The main
risk initiatives for the Clinical Educator will be provider
education, chart review, and ensuring accurate coding and
documentation across the organization. Optum Care CT IPA is a
dynamic group of physician-led medical groups across CT and is part
of the larger OptumCare national entity. The position requires
working with both local and national leaders. The IPA is a
multi-payor contracting vehicle that currently holds Medicare
Advantage risk contracts as well as shared savings contracts. Our
goal is to provide the highest quality of care at an affordable
cost for our members.In Connecticut, the Optum Care family is
growing. We have 570 primary care doctors, over 1,200 specialists
and a wide range of hospitals statewide. Together, we help the
people of Connecticut live healthier lives. -Our goal is to put
each person on the right course of care. We do this by giving you a
care team that works together to meet your needs. Together, you and
your care team can create a personal wellness plan.To us, success
is about your health and happiness. That's how we're helping to
create a health care system that works better for everyone.Our
office in Farmington -has an immediate opening for a friendly,
patient focused and detailed oriented Nurse-Clinical Educator to
join our team. This position will require travel throughout the CT
area. This is a full-time Monday-Friday position with hours between
8:00am-5:00pm.Primary Responsibilities:
- Work collaboratively with Clinical and technical resources to
ensure quality programs are effective and reporting is completed to
meet deadlines requirements
- Weekly touch points with IPA practice site resources to support
Risk and Quality programs and reporting
- Collaborate with Senior Quality Liaison to identify and support
5 STAR quality targets for OptumCare CT IPA
- Manage and Monitor IPA programs participation and outcomes
- Monitor Quality and Risk platforms regularly to assist IPA
practices in prioritizing outreach efforts
- Monitor and ensure that all users on the Quality platform are
properly trained to complete supplemental data submissions -
provide support -on rejections as needed
- Act as a Subject Matter Expert on Quality platforms and
supplemental data submissions
- Plan, conduct and coordinate all aspects of MRA (Medicare Risk
Adjustment) process evaluation and education to internal and
external partners
- Communicating a comprehensive understanding of Medicare Risk
Adjustment, Documentation & Coding guidelines
- Analyze reports to identify and report documentation/coding
trends to create opportunities for improvement with internal and
external partners
- Ensure provider documentation and diagnostic code selections
are appropriate and recommend improvements as necessary
- Continually assess the knowledge and appropriate application of
ICD-10 documentation and coding guidelines
- Leverage reporting benchmarks and MRA success measures to
prioritize efforts
- Demonstrate a professional and effective face to face
communication style and address issues as they arise
- Act as a Subject matter expert on Risk platformsThis is a full
time position with:
- Full Medical Benefits
- Paid Time Off
- Holidays
- 401k with company match
- Employee Stock Purchase Plan
- Employee Discount Program
- Tuition Assistance Program
- Fully Paid Training
- and more--- -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:
- Current, unrestricted RN license for the state of
Connecticut
- 3+ years of clinical practice experience, working in a provider
/ MD office setting
- Experience with Microsoft applications such as Word, Outlook,
Excel and PowerPoint
- Ability to travel within Connecticut offices to conduct on-site
education sessions
- 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 compliancePreferred Qualifications:
- BSN or MSN
- CPC or CRC certification
- 5+ years of clinical practice experience, working in a provider
/ MD office setting -
- 2+ years of experience working with Medicare Risk Adjustment
(MRA)
- Billing and coding OR medical office management experience
- Familiarity with outpatient / inpatient billing processes
- Solid understanding of coding principles -
- Excellent facilitation, consulting, and delivery of complex
content -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
employmentCareers 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)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.Connecticut Residents Only: -The salary range for
Connecticut residents is $60,000 to $106,700. 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**PLEASE NOTE** The Sign-On Bonus is only
available to external candidates. -Candidates who are currently
working for a UnitedHealth Group, UnitedHealthcare or a related
entity in a full time, part time, or per diem basis ("Internal
Candidates") are not eligible to receive a Sign On Bonus.
-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.
Keywords: UnitedHealth Group, New Britain , RN Clinical Educator - ProHealth Physicians - Farmington, CT, Healthcare , New Britain, Connecticut
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