Manager Coding Education

Optum STATE, (formerly Optum Tri-State NY) is seeking a Coding Educator to join our team in Middletown, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.

 

As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.

 

At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

 

The Coding Educator is responsible for developing and deploying the educational strategy and operations to ensure accurate and compliant Fee for Service code capture by providers throughout CRH, CMM, PHNY, RIV. The manager will develop and implement educational programs aimed at supporting accurate, complete, and compliant coding for government and commercial carriers in support of Revenue Cycle objectives and compliance. This individual will collaborate and partner with multiple stakeholders and leaders across the region.

 

Position Highlights & Primary Responsibilities:

• Evaluates and benchmarks FFS coding performance by market segment and uses insights to inform education and engagement strategy.
• Develops and implements active auditing program to support compliant code assignment.
• Ensures that coding compliance standards set by Optum are accounted for in all parts of the FFS coding education and engagement program
• Supports the deployment of point-of-care coding tools that promote complete and compliant capture.
• Partners with market leaders to implement efficient provider workflows across the region using national and regional infrastructure.

40% Operations Management:

• Implements FFS coding and Revenue Cycle initiatives that support clinical practice goals and efficient workflows for providers.
• Leads, manages and mentors coding education and engagement team to achieve completeness and accuracy of clinical documentation.
• Manages a strong education-focused team through effective recruiting, training, coaching, discipline, team building and succession planning to achieve a high level of staff satisfaction and performance.
• Handles difficult situations and people with tact, professionalism and discretion. Demonstrates good judgment in escalating difficult situations and people to Management personnel.
• Works with VP Revenue Integrity and Analytics team to scope dashboards to support consistent monitoring of provider and coding program performance. 
• Collaborates on program development using existing data assets and national team resources.
• Incorporates data and analytics into all components of innovation and decision-making related to risk adjustment

  

Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, CareMount Medical and ProHealth Care. The regional alignment combines resources and services across the care continuum – from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Together, we’re making health care work better for everyone.
 

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:

• National coding certification from AHIMA or AAPC
• 5+ years of experience in coding, auditing and provider education and engagement; regional, multispecialty business lines
• 5+ years of Healthcare financial management, healthcare consulting, and/or population health management
• Extensive business knowledge with a comprehensive understanding of coding and revenue cycle processes
• Comprehensive understanding of CPT I, CPTII, and ICD-10 code applications, auditing and each’s relationship to policy, contract and payer guidance
• Knowledge of health care and health policy regulatory requirements as it relates to coding and auditing
• Knowledge of and experience with implementing provider based educational programs, sharing feedback, and motivating behavior change
• Broad knowledge of data analytics including trend identification and process improvement strategy development

 

Preferred Qualifications:

• National coding certification from CCS
• Proven exemplary leadership skills and high degree of professional initiative
• Demonstrated high standard of excellence in auditing, coding and provider engagement programs
• Proven abilities to collaborate with departmental staff and multiple internal and external stakeholders; reconcile priorities and interests; and build alliances based on integrity, follow-through on commitments, and delivery of results
• Proven positive results and trusted relationship building with leadership and providers. Drives high-quality execution and operational excellence
• Proficiency in the use of Microsoft Office, Tableau, PowerBI applications and the ability to learn and apply new technologies and skills
• Manages effectively in a collaborative environment; manages onsite and remote resources and vendors
• Works with initiative, energy, and effectiveness in a fast-paced environment. Excels as a manager in a dynamically changing field
• Accurately performs extensive research across health care topics and effectively conveys information to providers and staff
• Able to skillfully navigate change management and develop best practice
• Manages multiple lines of business, successfully applying goal-oriented prioritization

 

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. 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.

 

OptumCare 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.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.