Optum Hiring For Hybrid RN Clinical Educator, ProHealth Physicians at Farmington, CT  Full Time

If you want to get way ahead in your career, it makes sense to be with an organization that’s way ahead of the curve. Formed in 1997, ProHealth Physicians has grown to become Connecticut’s leading primary care physician organization. With over 90 locations throughout the state of Connecticut, our family of primary care doctors and specialists care for more than 360,000 people statewide. In fact, ProHealth serves every county and provides roughly ten percent of the primary care delivered to patients in the state. We’re leaders in thinking and in serving our communities. For instance, we’re a C.M.S. approved Accountable Care Organization (ACO), covering over 30,000 Medicare patients associated with our community-based primary care providers. We’re also nationally recognized as a NCQA Level III Medical Home. That kind of progressive leadership makes us perfect fit for OptumCare and UnitedHealth Group’s expanding family of providers. This is a place where you can stay way ahead as you do your life’s best work.(sm)

ProHealth Physicians is a physician-led medical group with 85 practice locations throughout Connecticut serving more than 10% of the state’s residents. We empower physicians and advanced clinicians to better serve patients through enhanced care processes in support of improved patient outcomes. Formed in 1997, ProHealth Physicians has grown to include more than 350 primary care and specialty clinicians and offers select specialty and diagnostic/therapeutic services.

Position Details:

• Location: 3 Farm Glen Blvd, Farmington, CT 06032 (Hybrid Position)
• Department: Clinical Documentation Quality Improvement
• Schedule: Full time, 40 hours/weekly, Monday through Friday, 8:00AM – 4:30P, flexibility with hours. Travel may be required 1 day a week

If you are a local in the state of CT to be able to travel to sites and complete education sessions, you will have the flexibility to work remotely* as you take on some tough challenges.

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 platforms

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:

• Graduate of an accredited School of Nursing
• 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

Preferred 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)
• Experience using EMR AllScripts or Epic
• 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

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

Connecticut Residents Only: The salary range for Connecticut residents is $56,300 to $110,400. 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.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.

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.