Clinical Coding Nurse Consultant

3 weeks ago


Orlando, Florida, United States UnitedHealth Group Inc Full time

We are seeking a highly skilled Clinical Coding Nurse Consultant to join our team in Orlando, FL. As a Clinical Coding Nurse Consultant, you will play a critical role in driving consistent and efficient processes for Risk Adjustment improvement initiatives.

Job Overview

The ideal candidate will have a strong background in nursing and experience working with ICD10 codes. You will be responsible for developing and implementing market business plans to motivate providers to engage in improving Risk Adjustment metrics. This includes providing analytical interpretation of Risk Adjustment reporting, serving as a Subject Matter Expert (SME) for all Risk Adjustment related activities, and assisting in the development of training and analytical materials.

About the Role

This is a field-based position that requires travel within Orlando. The successful candidate will work collaboratively with regional/market teams and leadership in a matrix relationship, providing direction and guidance to Medical Coding Analysts and cross-functional team members. Key responsibilities include:

  • Developing and implementing market business plans to improve Risk Adjustment metrics
  • Providing analytical interpretation of Risk Adjustment reporting
  • Serving as a SME for all Risk Adjustment related activities
  • Assisting in the development of training and analytical materials
  • Overseeing DataRAP training and education delivery for Mega Groups
  • Leading weekly, monthly, bi-monthly, quarterly, and annual business review meetings

Requirements

To be successful in this role, you will need:

  • Bachelor's Degree in Nursing (or Associate's Degree or Nursing Diploma from an accredited nursing school with 2+ years of additional experience)
  • CPC certification or proof of obtaining certification within 9 months
  • 5+ years of experience in the healthcare industry
  • 1+ years of experience working with ICD10 codes
  • Strong analytical and problem-solving skills
  • Ability to persuade changes in behavior

What We Offer

We offer a competitive salary range of $83,000 - $115,000 per year, depending on experience, along with a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off. Our company values diversity and inclusion, and we are committed to creating a workplace where everyone feels valued and respected. If you are a motivated and detail-oriented individual who is passionate about improving healthcare outcomes, please submit your application today.



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