Nurse Clinical Educator Risk Adjustment

American Health Network, part of the Optum family of businesses, is seeking a Nurse Clinical Educator (Risk Adjustment) to join our team in Indiana and Ohio. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Nurse Clinical Educator (Risk Adjustment) will be responsible for the day-to-day management of Clinical Documentation programs, initiatives, and reporting as well as for Risk Adjustment activities for providers. In the Nurse Clinical Educator role, you would provide support to the teams implementing and reporting on these programs. The main initiatives for the Clinical Educator will be provider education, chart review, and ensuring accurate clinical documentation across the organization.

This is a full-time remote Monday-Friday position with hours between 8:00am-5:00pm. No evenings, weekends, or holidays!

If you reside in Indiana or Ohio, you'll enjoy the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Work collaboratively with Clinical and technical resources to ensure Clinical Documentation programs are effective and reporting is completed to meet deadlines requirements
• Weekly touch points with providers and practice site resources to support Clinical Documentation and Risk adjustment programs and reporting
• Manage and Monitor programs participation and outcomes
• Plan, conduct and coordinate all aspects of RA (Risk Adjustment) process evaluation and education to internal partners
• Communicating a comprehensive understanding of Risk Adjustment, Documentation & Coding guidelines
• Analyze reports to identify and report documentation/coding trends to create opportunities for improvement with internal partners
• Ensure provider documentation and diagnostic code selections are appropriate and recommend improvements as necessary
• Continually assess the knowledge and appropriate application of ICD-10 documentation and coding guidelines
• Leverage reporting benchmarks and Risk Adjustment success measures to prioritize efforts
• Demonstrate a professional and effective face to face communication style and address issues as they arise
• Act as a Subject matter expert on Risk platforms and tools

This is a full time position with:

• Full Medical Benefits
• Paid Time Off
• Holidays
• 401k with company match
• Employee Stock Purchase Plan
• Employee Discount Program
• Tuition Assistance Program
• Fully Paid Training
• and more...

At American Health Network, a part of Optum, transforming the delivery of health care across our region is our passion. Founded in 1994, we are an established multi-specialty, physician-led, integrated healthcare delivery system that cares for over 325,000 patients throughout our locations. Together, we're making health care work better for everyone.

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.

Required Qualifications:

• Current, unrestricted RN license in your state of residence
• Resident of Indiana or Ohio
• 3+ years of clinical practice experience, working in a provider / MD office setting
• Experience with Microsoft applications such as Word, Outlook, Excel and PowerPoint

Preferred Qualifications:

• BSN or MSN
• CPC or CRC certification
• 5+ years of clinical practice experience, working in a provider / MD office setting
• 2+ years of experience working with Risk Adjustment
• Billing and coding OR medical office management experience
• Familiarity with outpatient / inpatient billing processes
• Solid understanding of coding principles
• Proven excellent facilitation, consulting, and delivery of complex content

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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