VP, Middle Revenue Cycle Services Provider Operations

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

In this key leadership role, you will oversee the development and execution of service delivery commitments to continuously drive productivity, quality, and profitable growth by effectively leading Coding Services, Revenue Assurance, Clinical Documentation Integrity Services (CDI), and Health Information Management (HIM) supporting all applicable customers.

Under the guidance of the SVP, Provider Revenue Services Operations, the VP, Middle Revenue Cycle Services Provider Operations is responsible for providing strategic, financial, and operational leadership within the OptumInsight Middle division. This includes oversight of the day-to-day operations for:
assigned coding teams including Inpatient, Emergency, Observation, Ambulatory Procedures, Ambulatory Surgery, Ambulatory Clinics, Pathology and/or Radiology coding for our multitude of clients in accordance with accepted industry standards and practices and within established medical center(s) guidelines, leading and overseeing our concurrent and retrospective CDI program, all functions within our Revenue assurance pillar including revenue leakage identification, regulatory compliance, charge description master practices, audits, and maintenance, Correct Coding Initiative (CCI) edits, denial defense audits, self-pay audits, and stoploss audits, implementation of payer contracts, and our HIM operations pillar including chart completion, release of information, and documentation imaging and indexing.

The VP, Middle Revenue Cycle Services Provider Operations is responsible for providing strategic, financial, and operational leadership within the OptumInsight Middle operations organization. This includes oversight of the day-to-day operations within the following areas:  

• All assigned coding teams including Inpatient, Emergency, Observation, Ambulatory Procedures, Ambulatory Surgery, Ambulatory Clinics, Pathology and/or Radiology, for all clients and in accordance with accepted industry standards and practices and within established medical center(s) guidelines
• All functions within our revenue assurance operation including revenue leakage identification, regulatory compliance, charge description master practices, audits, and maintenance, Correct Coding Initiative (CCI) edits, denial defense audits, self-pay audits, and stoploss audits, implementation of payer contracts
• HIM operations including chart completion, release of information, and documentation imaging and indexing.

Success depends on driving efficiency, effective partnership, influence, and collaboration across various functions of OptumInsight, ensuring initiatives and strategy are targeting delivery of world class billing services, driving patient and customer commitment, and maximizing return through improved bad debt, cash realization and cost efficiencies.  This position is responsible for influencing change related to the key functions of Revenue Cycle through collaborative engagement with various matrixed teams to develop and support innovative initiatives that will achieve optimal results while identifying gaps in client support/performance.  

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

Primary Responsibilities:

• Accountable for all aspects of client focused Acute and Ambulatory coding, Revenue Assurance, CDI, and HIM Operations services delivery, including but not limited to driving delivery and execution against KPI’s and Service Level Agreement targets
• Provide leadership, coaching, and resource planning for the team
• Foster communication and relationships with Optum Client Executives and Matrix partners
• Act as functional subject matter expert internally and externally, lead best practices development and adherence and drive the Optum Playbook Model for all applicable service pillars
• Manage all functions of the applicable service pillars, including budgeting and program development
• Ensure daily operations and workflow quality in the applicable service pillars
• Handle client interactions and coordinate with internal teams
• Drive organizational efficiencies and develop scalable infrastructure and technology solutions
• Collaborate across departments to streamline processes and improve customer experience
• Assist in creating and maintaining medical coding documentation
• Set team direction, resolve problems, and provide guidance
• Adapt plans to address business and operational challenges
• Influence forecasting and planning activities
• Adhere to ethical coding standards by AAPC and/or AHIMA
• Maintain performance levels in coding quality and productivity

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:

• Bachelor’s degree in a Health Sciences discipline, Business Administration or related field; or an equivalent combination of education and/or work experience
• 10+ combined years of operational Coding and Health Information Management (HIM) leadership experience in a large multi-specialty hospital or equivalent health related organization. 
• Professional coder certification with credentialing from AHIMA and/or AAPC (CCS, RHIA, RHIT) to be maintained annually 
• Proficiency with MS Office applications and electronic medical records systems
• Proven communication, organizational, analytical and critical thinking skills
• Successful experience working within a multifaceted, highly matrixed organization
• Demonstrated ability to establish positive working relationships, effectively manage competing priorities, and accurately complete highly detailed work
• Demonstrated ability to drive organizational change and lead process improvement and automation initiatives
• Ability to communicate effectively with all levels of management and medical staff 
• Ability and willingness to travel as needed for offsite clients and/or internal meetings, conferences, and training sessions.
• Experience leading a team of 1000+ coders and HIM professionals across distributed geographic regions

Preferred Qualifications:

• Advanced business degree
• Experience working with offshore coding teams 
• Experience working with multiple vendors
• Experience with various systems including encoder (eCAC,3M, EPIC)
• Intermediate level of experience with Microsoft Excel

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

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $188,000 to $357,600 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

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.

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.