Senior Clinical Coding Nurse Consultant

1 week ago

Round Rock, United States Optum Full time
Job Title: Senior Clinical Coding Nurse Consultant

At Optum, we are committed to helping people live healthier lives and making the health system work better for everyone. We are seeking a highly skilled and experienced Senior Clinical Coding Nurse Consultant to join our team.

The Senior Clinical Coding Nurse Consultant will play a critical role in driving consistent, efficient processes and sharing best practices in a collaborative effort with Providers and Market Team. This position will be responsible for developing and implementing market business plans to motivate providers to engage in improving Risk Adjustment metrics.

The ideal candidate will have a strong background in clinical coding and risk adjustment, with experience in managed care working with network and provider relations. They will possess excellent analytical and problem-solving skills, with the ability to interact with medical staff, peers, and internal company staff at all levels.

The Senior Clinical Coding Nurse Consultant will work collaboratively with each regional/market team and their leadership in a matrix relationship. They will provide direction and guidance to Medical Coding Analysts, as well as cross-functional team members within their respective Markets pertaining to Risk Adjustment.

The successful candidate will have a strong understanding of the Medicare market, products, and competitors, as well as knowledge of clinical standards of care and preventative health measures. They will be able to analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies related to Risk Adjustment.

The Senior Clinical Coding Nurse Consultant will be responsible for developing solution-based, user-friendly initiatives to support practice success. They will oversee market-specific chart retrieval and review of PCP, Hospital, and Specialist records. They will work with DataRAP Senior Leadership on identified special projects.

The ideal candidate will have a strong passion for delivering equitable care that addresses health disparities and improves health outcomes. They will be committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

We are 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.

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