Director - Risk Adjustment Coding Quality and Compliance - Remote

UnitedHealth Group

  • Eden Prairie, MN
  • $132,200-226,600 per year
  • Permanent
  • Full-time
  • 30 days ago
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.Oversee coding compliance to ensure compliant with coding regulations and guidelines. Establish and maintain coding policies in collaboration with the Risk Adjustment Steering Sub Committee. Serve as a subject matter expert for Risk Adjustment coding, Risk Adjustment Data Validation, and other Government audits. Ensure operations are adherent to compliance policies and contractual obligations. Monitor industry regulations and stay informed of coding changes and updates.You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
  • Meet with clients to discuss quality audits and coding processes
  • Review and respond to client audits
  • Provide input to coding tools and processes
  • Execute RADV and other Government audits
  • Respond to RFPs/present to potential customers
  • Execute projects assigned
  • Review and approve contract language related to coding and SLAs
  • Analyze data to make recommendations or identify issues or opportunities
  • Partner with cross functional teams within RQ operations
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:
  • Coding certification- AAPC (CPC) and, or AHIMA
  • 10+ years of Risk Adjustment coding experience
  • 5+ years of Coding Quality management experience
  • 5+ years of Coding Compliance and regulatory understanding and experience
  • 3+ years of People management experience
  • 3+ years of Exposure to Technology and AI
  • 2+ years of experience with Data analytics tools-Power BI
  • Intermediate or higher level of experience using MS Office (Excel, PPT,Word)
Preferred Qualification:
  • CRC certification
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $132,200 to $226,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves 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.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group