RN Clinical Educator - ProHealth Physicians - Farmington, CT

* $1,000 SIGN ON BONUS FOR ALL NEW EXTERNAL HIRES *

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

The Nurse Quality/Clinical Educator (Risk Adjustment) will be responsible for the day to day management of Quality programs, initiatives, and reporting as well as for Risk Adjustment activities for Optum Care Network of Connecticut providers. The existing quality programs at Optum Care CT IPA are recognized as the best in the state by many business partners. In the Quality role, you would provide support to the teams implementing and reporting on these programs. The main risk initiatives for the Clinical Educator will be provider education, chart review, and ensuring accurate coding and documentation across the organization. Optum Care CT IPA is a dynamic group of physician-led medical groups across CT and is part of the larger OptumCare national entity. The position requires working with both local and national leaders. The IPA is a multi-payor contracting vehicle that currently holds Medicare Advantage risk contracts as well as shared savings contracts. Our goal is to provide the highest quality of care at an affordable cost for our members.

In Connecticut, the Optum Care family is growing. We have 570 primary care doctors, over 1,200 specialists and a wide range of hospitals statewide. Together, we help the people of Connecticut live healthier lives.

Our goal is to put each person on the right course of care. We do this by giving you a care team that works together to meet your needs. Together, you and your care team can create a personal wellness plan.

To us, success is about your health and happiness. That’s how we’re helping to create a health care system that works better for everyone.

Our office in Farmington has an immediate opening for a friendly, patient focused and detailed oriented Nurse-Clinical Educator to join our team. This position will require travel throughout the CT area. This is a full-time Monday-Friday position with hours between 8:00am-5:00pm.

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

This is a full time position with:

• Full Medical Benefits
• Paid Time Off
• Holidays
• 401k with company match
• Employee Stock Purchase Plan
• Employee Discount Program
• Tuition Assistance Program
• Fully Paid Training
• and more…
  

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:

• 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
• Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance

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)
• 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
  

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Connecticut Residents Only: The salary range for Connecticut residents is $60,000 to $106,700. 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

**PLEASE NOTE** The Sign-On Bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis (“Internal Candidates”) are not eligible to receive a Sign On Bonus.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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