UnitedHealth Group Advanced Practice Clinical Educator - Overland Park, KS in Overland Park, Kansas
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Responsible for the delivery and implementation of all clinical education materials and initiatives to employed and/or contracted providers, as well as KPIs within their region designed to ensure appropriate practices related to risk adjustment activities, HEDIS measures, and any appropriate gaps in care. The Clinician Educator is also responsible for overseeing the work of the provider chart reviews to inform healthcare providers of potential inferred, embedded, out of date, inaccurate, and/or missed diagnoses not previously identified, and aid in the education and discovery of opportunities for improved quality of care and compliance through accurate coding and documentation. The Clinician Educator is further responsible for keeping up to date on changes in the Medicare risk adjustment model and other documentation requirements.
The Clinician Educator works collaboratively with the regional Medical and/or Clinical Director(s), Risk Adjustment program director, other Clinician Educators, coding department, lead physicians, site administrators, primary care physicians, specialists, surgeons, and hospitalists to educate on and improve accurate documentation and coding skills, leading to a more complete patient record.
Serves as a resource for the region, network, and national operations on proper coding and documentation
Provides education to employed and contracted physicians, APRNs, and PAs on appropriate supporting documentation, assists in workflow development when requested, and ensures compliant documentation standards are met
Recommends ongoing chart review process to ensure continued high standards in documentation and coding
Responsible for onboarding, ongoing, and targeted education of all physicians on coding and documentation for Medicare risk adjustment
Be accountable for the overall improvement and performance in risk adjustment, HEDIS, and any appropriate gaps in care metrics
Attend network and clinic site meetings as appropriate to present material on documentation and coding
Review charts to aid in the education process and discover opportunities to improve accurate documentation and coding
Attends courses to improve/maintain current and up-to-date knowledge of documentation and coding
Meet regularly with regional Risk Adjustment Medical and/or Clinical Director(s); send updates on activities weekly to network risk adjustment leadership and clinical operations teams.
Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care, and concern with every internal and external customer
Implements programs designed to ensure all diagnosed codes and conditions are properly supported through appropriate documentation in patient chart. Programs include, but are not limited to, training and educational activities and coordination of random targeted documentation audits and concurrent follow up feedback
Meets with regional Medical and/or Clinical Director to assist in identification of operational and clinical best practices in maximizing patient visits, re-evaluation rates, and accurate and proper coding; assists in the dissemination of best practices to sites, clinicians, and IPA providers/support staff
Teaches clinicians in group settings, the general principles on documentation and coding
Engages clinicians on continuous dialogue regarding optimizing documentation and coding, and associated workflows
Creates and modifies the curriculum for mentoring, small group education, and large group education sessions
Attends and participates as requested in regional and corporate meetings that pertain to documentation and coding
Maintains knowledge around year-over-year changes to the risk adjustment model
Assists in sharing of best practices related to risk adjustment activities with other regions within the network
Completes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signs agreements
Ensures confidentiality of patient information following HIPAA guidelines and company policies
Attends documentation and coding training and integrates learning into chart review processes
Attends training to meet requirements of the job position and as needed or mandated by company policies, Division of Occupational Safety & Health (DOSH), OSHA, L&I, and other state/federal regulations
Uses, protects, and discloses Optum’s patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Assists Risk Adjustment Director in meeting compliance and regulatory standards
Performs additional duties as assigned
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Advanced degree as a NP or PA
Current and unrestricted license to practice medicine in Kansas.
2+ years of experience as a primary care NP or PA
Experience in chart review and documentation inside an Electronic Medical Record (EMR)
Excellent range of knowledge with respect to the practice of medicine
Ability to analyze and interpret data
Advanced computer skills
Knowledgeable in Microsoft Word, Excel, and PowerPoint
Ability to effectively interface with teammates and clinicians
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.
Excellent verbal and written communication skills
Ability to work independently
Ability to speak clearly and communicate with patients, families, agencies, other providers, and staff regarding patient care
Ability to develop positive interaction with patients, families, physicians, administrators, and co-workers to effectively care for the patient
Ability to stand continuously
Ability to sit continuously
Ability to walk continuously
Ability to kneel/crouch
Ability to lift up to 10lbs
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
At OptumCare, we’ve found that putting clinicians at the center of care is the best way to improve lives. Our physician-led organization is one of the most dynamic and progressive health care organizations in the world, serving over 17 million people through more than 45,000 aligned physicians and 9,000 advanced practice clinicians. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Learn more at www.workatoptum.com.
Would you thrive with OptumCare?
Do you practice evidence-based medicine?
Are you seeking a practice focused on patient-centered quality care, not volume?
Are you a team player - comfortable delegating and empowering teams?
Are you constantly seeking better ways to do things?
Do you want to be part of something better?
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)
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.