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UnitedHealth Group Clinical Documentation Improvement Manager - Walnut Creek, CA or Western US in Concord, California

Bring us your experience, your head for strategy, your strength with relationships and your eye for opportunity. In return we offer an unmatched place to grow and develop your career among a richly diverse group of businesses driven by the power and stability of a leading health care organization. Come help us heal and strengthen the health care system as you do your life's best work.(sm)

Optum360, an industry leader in healthcare implementation and consulting services, is adding additional talent to our Revenue Cycle Optimization Team. Ideal candidates will have experience in multiple functional revenue cycle areas which include Patient Financial Services, Patient Access, Registration and Middle Revenue Cycle, Revenue Integrity and Patient Financial Services. This is a full time position that would allow employees to see career growth while taking on challenging engagements around the United States.

Our staff serve as industry experts while they implement best practices in Optum360 client/partner locations. They combine their leadership, experience and understanding of Optum360 solutions to bring world class results in Revenue Cycle Projects and end-to-end partnerships.

The Clinical Documentation Improvement Manager will serve as a subject matter expert while working to implement best practices in Optum client locations. Our staff combine their leadership, experience and understanding of Optum360 technology, structure and methodology solutions to drive results while coordinating efforts with Optum360 Revenue Cycle Optimization team, Optum360 Technology teams, Optum360 Project Management Office, and Optum360 Coding and Compliance team. Typical projects for our team include, but are not limited to:

  • Revenue cycle assessments

  • Coding accuracy/improvement programs

  • Computer Assisted Coding (CAC) Technology Implementation

  • Clinical Documentation Improvement programs and CDI Technology implementation

  • DNFB, Failed Claims and DRG denial reduction

  • Charge capture and accuracy enhancement

  • Revenue Integrity and Transfer DRG

  • Alignment of client processes, structure and methodology and Optum technology

  • Interim management as needed

If you are located in the Western United States, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Provide revenue cycle management services to client/partners in all areas of the healthcare revenue cycle which includes:

  • Patient access (scheduling, preregistration, insurance verification/financial counseling)

  • Registration/Admission (ED, inpatient, outpatient, ambulatory)

  • Health Information Management (transcription, coding, clinical documentation improvement)

  • Patient financial services (charge capture, pre-billing, billing, follow-up, cash posting, account resolution)

  • Decision support and analytics

  • Productivity and quality management

  • Successfully lead and manage a diverse group of professionals and personalities on large complex engagements by fostering a collaborative team culture

  • Orchestrate multiple complex work streams through others by directing and leading, not necessarily doing

  • Document findings, impacts and recommendations within assessment deliverables; responsible for the revenue cycle sections within each deliverable

  • Collaborate with assessment team (Clinical, IT and PM) in developing overall strategic findings and recommendations based on areas of risk or opportunity identified during interviews

  • Communicate effectively (written and verbal) to a variety of audiences; must be able to persuade and influence the actions of others; Interactions will range from routine to complex and include formal and informal presentations, one-on-one and group discussions

  • Prepare final client status reports and create presentations to clients and engagement staff that demonstrate full command of factual material

  • Manage day-to-day client relationships including executive management

  • Play a key role in the retention, professional development and performance review of staff, including the mentoring, coaching and recruiting of staff

  • Identify client/partner barriers in achieving operational excellence

  • Understand client/partner business metrics and results

  • Evaluate and analyze client/partner data to understand trends in all areas of the operation

  • Development of options and recommendations for client/partner improvement

  • Perform benefit modeling and financial analyses that clearly demonstrate the value of our solution to clients and prospective clients

  • Collaborate with client/partner revenue cycle team and other departments in order to facilitate resolution of process issues and implement world-class solutions

  • Provide informed feedback to Optum360 and client/partner executives including assessments of processes, standards, suggestions and improvements

  • Develop work plans, project tasks and manage projects in accordance with budget

  • Provide interim staffing services as required

Required Qualifications:

  • Bachelor’s Degree or equivalent experience

  • 10+ years of project management, account management or client management experience

  • Experience with Microsoft Office Suite including Microsoft Excel (ability to create spreadsheets, sort and filter data) and Microsoft PowerPoint (ability to create slides, upload graphs, and present data)

  • Experience evaluating and determining appropriate course of action to meet business-client needs

  • Demonstrated self-starter with strong planning organization, analytical and problem-solving skills

  • Experience working with project stakeholders/business leadership team

  • Strong written and verbal communication skills, including well-developed interpersonal skills

  • 10+ years’ experience working in hospital health information management department as a manager, or minimum of 10 years’ experience in the healthcare revenue cycle required

  • 10+ years prior leadership experience

  • Proficient in Acute Healthcare Revenue Cycle programs and Technology

  • Understanding of basic healthcare accounting tools/billing editors (ie. Meditech, Epic, SSI, Emdeon, Mckesson)

  • Solid understanding of revenue cycle workflow in the hospital and ambulatory environment (registration, scheduling, coding, billing, contracting)

  • Revenue cycle consulting experience, such as revenue cycle outsourcing, interim management or performance improvement preferred

  • Experience and comfort working at all levels of a health care organization

  • Working knowledge of hospital based IT systems

Preferred Qualifications:

  • Clinical Documentation Improvement Specialist (CDIS) Certification

  • Registered Nurse

  • Flexible, agile and adaptable to change

  • Knowledge of Optum service delivery model and operations

  • Ability to lead, motivate, influence, probe, analyze, synthesize and articulate complex subject matter so it can be easily understood

  • A high degree of self-motivation, versatility and flexibility

  • Excellent interpersonal, written, and oral communication and presentation skills

  • Ability to adapt to a flexible schedule

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Diversity creates a healthier atmosphere: UnitedHealth Group is 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.

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

Job Keywords: Hospital Health Information Management, Revenue Cycle, Clinical Documentation Improvement Manager, Walnut Creek, CA, California, Western United States, telecommute, telecommuter, telecommuting