Risk Adjustment Validation Audit Manager

Risk Adjustment Validation Audit ManagerOptum 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 Manager oversees the end-to-end business process activities by creating, controlling, and improving business processes. Will assist with process design and oversee project implementation, diagnosing process improvement opportunities and develop solutions using principles of process excellence and related tools. Will evaluate quality reporting, analysis, audits, developing plans and programs to support RADV process using a variety of applicable tools.Primary Responsibilities:Monitor quality activities to increase departmental accuracy and efficiency, including but planning, development, and implementation of improvement areasReview analysis of audit findings quality trends and noncompliance issues detected through auditingCollaborate with team supervisors to develop best practices for communicating areas of improvementManage the implementation of proactive solutions to mitigate risk that will impact project qualityIncorporate feedback from operational and QA reports to improve performanceAssess, evaluates, and addresses variance in production and key goals for operationsParticipates in team meetings/discussions of quality trends reported by team membersRequired Qualifications:Coding Certification, i.e., CCS, CCS-P, CPC, CPC-H or CRN-C5+ years of experience auditing Risk Adjustment records1+ years of Risk Adjustment Data Validation Audit experience1+ years working in an Operations/Production environment1+ years of experience as a manager, responsible for performance managementExperience tracking employee's KPI's (Key Performance Indicators)Intermediate (or higher) MS Office (Word, Excel & Outlook)Proven excellent interpersonal, written, and verbal communication skillsProven excellent organizational ability to manage multiple projects and perform in a deadline driven environmentProven ability to maintain professionalism and a positive service attitude at all timesProven intense focus, attention to detail, and due diligence are paramount for this roleNo previous connection to the audit being performedMust be 18 years or olderPreferred Qualifications:Certified Risk Adjustment CoderSolid team player with 2+ years of leadership experienceRHIA, RHIT, or Healthcare experienceInpatient and Outpatient Coding experienceExperience 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)Technical expertise in ICD-10-CMKnowledge of Risk Adjustment Data Validation (RADV) Coding GuidelinesProven ability to assimilate and adapt quickly and accuratelyAvailability Requirements:Onshore: Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm CST. It may be necessary, given the business need, to work weekends.Offshore: Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm IST. It may be necessary, given the business need, to work weekends.Telecommuting Requirements:Ability to keep all company sensitive documents secure (if applicable)Required to have a dedicated work area established that is separated from other living areas and provides information privacyMust live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet servicePay 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 are 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 $89,900 to $160,600 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.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.