Field-Based Healthcare Advocate: Risk & Quality Leader

Optum; Bethesda (MD); Presencial; USD 73.000 - 130.000; Jornada completa

Descripción de la vacante

UnitedHealth Group | Optum Insight is seeking a Healthcare Advocate for a field-based role covering Maryland and the District of Columbia. You will partner with physicians and medical groups to ensure accurate documentation and coding, driving RAF performance and quality initiatives.

The role requires 3+ years in healthcare, EMR experience, and travel up to 80%. You will lead training, data analysis, and strategic engagement to improve Medicare Advantage, Medicaid, and ACA programs.

Formación

• 3+ years of healthcare experience with solid knowledge of medical terminology and clinical issues.
• 2+ years of experience with EMR systems.
• Experience in a physician office, clinic, hospital, or similar medical setting.
• Demonstrated knowledge of ICD-10, HEDIS, and Stars programs.
• Proficiency in MS Office (Excel, Word, PowerPoint) with ability to manipulate data, create documents, and deliver presentations.
• Willingness to travel approximately 80% of the time in MD/DC region and daily local state travel.
• Must have a valid Driver’s License, reliable transportation, and current auto insurance.

Responsabilidades

• Act as a trusted advisor and strategic partner to providers and medical groups, assisting in accurate documentation and coding to reflect members’ true health status.
• Travel independently across the assigned territory (approximately 80% field-based, with occasional overnight travel) to engage providers in Optum tools and programs that enhance quality of care for Medicare Advantage members.
• Responsible for gaining participation and deployment of Prospective Programs achieving business goals and metrics.
• Utilize data analysis to identify and target providers who would benefit from coding, documentation, and quality training resources.
• Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and Hospitals.
• Develop and implement comprehensive, provider-specific plans to improve RAF performance, coding specificity, and gap closure.
• Manage end-to-end Risk Adjustment and Quality programs, including In-Office Assessment initiatives.
• Consult with provider groups on documentation and coding gaps; provide actionable feedback to improve compliance with CMS standards.
• Offer guidance on EMR/EHR system issues impacting documentation and coding accuracy.

Conocimientos

Healthcare experience

EMR systems

MS Office

Data analysis

Descripción del empleo

UnitedHealth Group | Optum Insight is seeking a Healthcare Advocate for a field-based role covering Maryland and the District of Columbia. You will partner with physicians and medical groups to ensure accurate documentation and coding, driving RAF performance and quality initiatives.

The role requires 3+ years in healthcare, EMR experience, and travel up to 80%. You will lead training, data analysis, and strategic engagement to improve Medicare Advantage, Medicaid, and ACA programs.