Per Diem Clinical Quality Analyst - National Remote
: Job Details :

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come makes an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

This position is part time (up to 20 hours/week) from January - April. Employees are required to have flexibility to work any of our shift schedules during our normal business hours. It may be necessary, given the business need, to work occasional overtime.

We offer 1 week of on-the-job training with the ability to complete full training needs during the first week of class. The hours of training will be aligned with your schedule.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Jobs in this function provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. *Employees in jobs labeled with ‘SCA' must support a government Service Contract Act (SCA) agreement.

• Extensive work experience within own function.
• Work is frequently completed without established procedures.
• Works independently.
• May act as a resource for others.
• May coordinate others' activities.- Extensive work experience within own function.
• Meet and maintain production and quality expectations for all assigned measures.
• Perform daily responsibilities with acute attention to detail.
• Transition between priorities and abstraction projects based on program or client needs.
• Responsible for managing and utilizing confidential information from medical records in an appropriate manner following designated guidelines including HIPAA and company policies/guidelines.
• Applies HEDIS® concepts and principles in the completion of abstraction and review process to ensure full recognition of delivered care for the benefit of the member.
• Ability to work in a self-directive manner and apply critical thinking/problem solving skills by referencing available Technical Specifications, Business Process Documentation, Job Aids, and other tools for clarity/guidance as needed
• Demonstrates adaptability in a highly changing environment, quickly and effectively shifting focus as priorities change

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:

• High School Diploma / GED
• 18 years of age or older
• 2+ years of healthcare experience
• 2+ years of experience reviewing medical records.
• 1+ year of HEDIS® experience, performing a wide range of functions with strong focus on medical record review and clinical oversight.
• Ability to use Microsoft applications such as Outlook daily
• Ability to complete full training needs during the first week of class
• Ability to work nights and/or weekends during peak seasons as needed
• Ability to work per diem (up to 20 hours/week) from January - April. Employees are required to have flexibility to work any of our shift schedules during our normal business hours.

Preferred Qualifications:

• Coding certificate from AAPC or AHIMA OR Clinical Certification such as LPN, RN, or CNA (Certified Nursing Assistant)
• 2+ years of experience in a health care delivery organization
• Knowledge of Medicaid and/or Medicare programs
• Proficiency in presentation skills to audiences of various sizes
• Knowledgeable of current trends in HEDIS® in managed health care.
• Knowledgeable of NCQA, Stars, HEDIS®, HOS and CAHPS requirements.
• Familiarity with ICD-9-CM, CPT, DRG, LOINC, HCPCS, TOB, POS, NDC coding.

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $28.03 to $54.95 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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 the volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

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