Risk Adjustment Validation Audit Supervisor – Remote

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.

 

The Risk Adjustment Validation Audit Supervisor assists with the end – to – end business process activities by creating, controlling, and improving business processes. Will assist with project implementation for improvement activities, diagnosing process improvement opportunities and assist in the development of solutions using principles of process excellence and related tools. Also assists in quality reporting, analysis, audits, developing plans and programs to support RADV process using a variety of applicable tools.

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

• Supervise medical record reviews, risk adjustment code abstraction, and quality assurance auditing for Medicare RADV audits
• Responsible for quality monitoring activities to increase departmental accuracy and efficiency, including identifying areas of improvement, and planning the implementation of improvement areas
• Collaborates with team on best practices for communicating areas of improvement
• Identifies variances and implements proactive solutions to mitigate risk that will impact project quality
• Communicates feedback from operational and QA reports to improve performance
• Assesses, evaluates, and addresses daily workload and manages day-to-day and production operations
• Participates in team meetings/discussions of quality trends reported by team members

 

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:

• Certified Risk Adjustment Coder
• Coding Certification, i.e., CCS, CCS-P, CPC, CPC-H or CRN-C
• 3+ years of experience auditing Risk Adjustment records
• 1+ years of Risk Adjustment Data Validation Audit experience
• 1+ years of experience as a supervisor, responsible for performance management
• 1+ years working in an Operations/Production environment
• Experience utilizing claims data to target areas within the medical record to abstract ICD-10-CM codes that risk adjust within the v24 and V28 CMS Hierarchical Condition Categories (HCCs)
• Excellent organizational ability to manage multiple projects and perform in a deadline driven environment
• Ability to maintain professionalism and a positive service attitude at all times
• Demonstrated intense focus, attention to detail, and due diligence
• Experience tracking employee’s KPI’s (Key Performance Indicators)
• Excellent interpersonal, written, and verbal communication skills.
• Intermediate (or higher) MS Office (Word, Excel & Outlook), Proficiency with Microsoft Word (ability to create, edit, save, and send documents), Microsoft Excel (ability to create, edit, save, and send spreadsheets), and Microsoft PowerPoint (ability to create, edit, save, and send presentations)
• Proven to have no previous connection to the audit being performed
• Must be 18 years of age OR older

 

Preferred Qualifications:

• RHIA, RHIT, or Healthcare experience
• Solid team player with 2+ years of leadership experience
• Inpatient and Outpatient Coding experience
• Knowledge of Risk Adjustment Data Validation (RADV) Coding Guidelines
• Technical expertise in ICD-10-CM
• Ability to assimilate and adapt quickly and accurately

 

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

 

Pay 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 re 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 $71,200 to $127,200 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.