Introduction to Our Company and Industry
As a leader in the healthcare industry, our company is dedicated to improving the quality of care for Medicare Advantage members. We are seeking a highly skilled and passionate Telecommute Healthcare Advocate to join our team. This is a unique opportunity to make a difference in the lives of patients and healthcare providers while working in a modern, remote environment. Our company values innovation, collaboration, and excellence, and we are committed to providing our employees with a supportive and dynamic work environment.
Job Overview
In this role, you will have the flexibility to telecommute from Western, KY, and will be responsible for traveling across your assigned territory to meet with healthcare providers and discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage members. You will utilize data analysis to identify and target providers who would benefit from our coding, documentation, and quality training and resources. Your goal will be to establish positive, long-term, consultative relationships with physicians, medical groups, IPAs, and hospitals, and to develop comprehensive, provider-specific plans to increase their RAF performance and improve their coding specificity.
Primary Responsibilities
- Functioning independently, travel across assigned territory to meet with providers to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage members (approximately 80% of time)
- Utilize data analysis to identify and target providers who would benefit from our coding, documentation, and quality training and resources
- Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs, and hospitals
- Develop comprehensive, provider-specific plans to increase their RAF performance and improve their coding specificity
- Manage end-to-end Risk and Quality Client Programs, including the Healthcare Patient Assessment Form, to ensure accurate payments are occurring for each provider based on client contract
- Consult with provider groups on gaps in documentation and coding
- Provide feedback on EMR/EHR systems where it is causing issues in meeting CMS standards of documentation and coding
- Partner with a multi-disciplinary team to implement prospective programs as directed by Market Consultation leadership
- Assist providers in understanding the Medicare quality program and CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
- Support providers in ensuring documentation supports the submission of relevant ICD-10 codes and CPT2 procedural information in accordance with national coding guidelines and appropriate reimbursement requirements
- Provide ICD10-HCC coding training to providers and appropriate office staff as needed
- Develop and present coding presentations and training to large and small groups of clinicians, practice managers, and certified coders
- Develop and deliver diagnosis coding tools to providers
- Train physicians and other staff regarding documentation, billing, and coding, and provide feedback to physicians regarding documentation practices
- Provide measurable, actionable solutions to providers that will result in improved accuracy for documentation and coding practices
- Collaborate with doctors, coders, facility staff, and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts
- Assist in collecting charts where necessary for analysis
Requirements and Qualifications
To be successful in this role, you will need to have a strong foundation in healthcare and a diverse skillset. The following qualifications are required:
- Bachelor's degree (preferably in Healthcare or a related field) or equivalent work experience
- Proficiency in MS Office (Excel, PowerPoint, and Word), including experience with pivot tables and Excel functions
- Ability to work effectively with common office software, coding software, EMR, and abstracting systems
- Excellent verbal and written communication skills, with the ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand
- Proven ability to effectively engage, manage, and maintain relationships with physicians, hospitals, health systems, clinical, and non-clinical personnel
- Ability to travel within the state up to 75% of the time to client locations
- Full COVID-19 vaccination is an essential job function of this role, and candidates must comply with all federal, state, and local regulations, as well as client requirements
Preferred Qualifications
While not required, the following qualifications are preferred:
- Experience working in a healthcare setting, preferably with Medicare Advantage members
- Knowledge of Optum tools and programs, as well as CMS standards and regulations
- Experience with data analysis and reporting, including the ability to identify trends and areas for improvement
- Strong presentation and training skills, with the ability to develop and deliver engaging presentations to large and small groups
- Experience working with EMR/EHR systems and coding software
Skills and Competencies
To be successful in this role, you will need to possess a range of skills and competencies, including:
- Strong analytical and problem-solving skills, with the ability to analyze complex data and identify areas for improvement
- Excellent communication and interpersonal skills, with the ability to build strong relationships with healthcare providers and other stakeholders
- Strong presentation and training skills, with the ability to develop and deliver engaging presentations to large and small groups
- Ability to work independently and as part of a team, with a strong focus on collaboration and partnership
- Strong organizational and time management skills, with the ability to prioritize tasks and manage multiple projects simultaneously
- Ability to adapt to changing priorities and deadlines, with a strong focus on flexibility and resilience
Career Growth and Development
At our company, we are committed to providing our employees with opportunities for career growth and development. As a Telecommute Healthcare Advocate, you will have access to a range of training and development programs, including:
- Comprehensive onboarding program to ensure a smooth transition into the role
- Ongoing training and development programs to enhance your skills and knowledge
- Opportunities for career advancement and professional growth
- Access to a range of resources and tools to support your success in the role
Work Environment and Company Culture
Our company values a positive and supportive work environment, and we are committed to providing our employees with a dynamic and engaging workplace. As a Telecommute Healthcare Advocate, you will be part of a team that is passionate about improving the quality of care for Medicare Advantage members, and you will have the opportunity to work with a range of stakeholders, including healthcare providers, patients, and other employees.
Our company culture is built on a foundation of innovation, collaboration, and excellence, and we are committed to providing our employees with a supportive and inclusive work environment. We value diversity and inclusion, and we are committed to creating a workplace that is welcoming and inclusive to all employees.
Compensation and Benefits
We offer a competitive compensation package, including a salary range that is commensurate with experience. In addition to your salary, you will also be eligible for a range of benefits, including:
- Comprehensive health insurance program
- Retirement savings plan
- Paid time off and holidays
- Opportunities for career advancement and professional growth
- Access to a range of resources and tools to support your success in the role
Conclusion
If you are a passionate and experienced healthcare professional who is looking for a new challenge, we encourage you to apply for this exciting opportunity. As a Telecommute Healthcare Advocate, you will have the opportunity to make a real difference in the lives of patients and healthcare providers, while working in a modern and dynamic work environment. Don't miss out on this opportunity to join our team and take your career to the next level. Apply today!
Apply Now