UnitedHealth Group Supervisor-Quality and Risk Management - Tampa, FL in Riverview-Florida, Florida

Supervisor - Quality and Risk Adjustment is responsible for coordinating the day - to - day operations of the Clinical Quality Analyst (CQA) program by overseeing the workflow of the clinical coding team, facilitating staff and client communications and serving as a liaison between staff and management team members. Additional responsibilities include training new employees, providing coaching and counseling for employees as needed and serving as a project team member for initiatives pertaining to the continued development of the Clinical Quality Analyst (CQA) program.

Position is primarily based in Tampa, but travel throughout other Florida markets will be required.

Primary Responsibilities:

  • Provides day - to - day supervision of clinical quality analyst team

  • Oversees staffing assignments for the clinical quality analyst team

  • Conducts technical training and coaching sessions for new employees and existing staff

  • Strategically supports the continued development of the clinical quality analyst medical record review process and resource tools through project team involvement and leadership

  • Audits program outputs for performance and productivity goal attainment

  • Provides input and feedback on employee performance and conducts counseling and disciplinary actions as necessary

  • Provides coverage for field assignments, as needed

  • Analyze errors in submissions and work on process improvement plans

  • Work with network managers, medical director, market leader, cross functional team and other stakeholders to improve coding accuracy

  • Assist with HEDIS and stars quality performance improvement activities

Required Qualifications:

  • Current Registered Nurse (RN) in applicable state or non-licensed medical school graduate

  • 5 + years of clinical and / or comparable medical records experience

  • CPC certification or proof that certification has been obtained within 9 months of hire date from the American Academy of Professional Coders

  • Ability and willingness to travel a minimum of 50%, (locally and non - locally) as determined by business need

  • Must have strong analytical skills and an understanding and application of ICD - 10 coding

  • Must be able to review medical charts to extract necessary data in a systematic and efficient manner

  • Proficiency with Microsoft Office applications

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.

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are 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 and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job keywords: RN, Medical school graduate, clinical quality, Risk Adjustment, training, CQA, HEDIS, Coding, Tampa, FL, Florida