Field-Based Risk Adjustment Specialist

UnitedHealth Group; St. Louis (MO); On-site; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group is seeking a Healthcare Advocate for field-based work in Saint Louis, MO. You will partner with physicians, medical groups, IPAs and hospitals to improve documentation and coding for Medicare Advantage, Medicaid, and ACA programs, driving RAF performance and quality outcomes.

Requires 2+ years in medical settings, ICD-10/HEDIS/Stars experience, and EMR proficiency. 75% travel and MS Office skills are essential for success in this role.

Qualifications

• 2+ years in a physician office, clinic, hospital, or similar medical setting.
• 2+ years of ICD-10, HEDIS, and Stars programs.
• 1+ years with EMR systems.
• Proficiency in MS Office (Excel, Word, PowerPoint) and data manipulation.
• Strong communication across stakeholders and teams.
• Self-driven, goal-oriented, able to work independently.
• Ability to travel up to 75% within designated market.
• Current driver's license and reliable transportation.

Responsibilities

• Act as a trusted advisor to providers, assisting in accurate documentation and coding.
• Travel 75% within the territory to engage providers and drive quality improvements.
• Develop provider-specific plans to improve RAF performance and gap closure.
• Utilize data to identify providers benefiting from coding and quality training resources.
• Establish long-term relationships with physicians, medical groups, IPAs, and hospitals.
• Lead end-to-end Risk Adjustment and Quality programs and in-office assessment initiatives.
• Guide on CMS documentation standards and ICD-10/CPT II alignment.
• Collaborate with teams to implement prospective programs as directed by leadership.
• Educate providers on Medicare quality programs and risk adjustment methodologies.

Skills

Medical setting experience

ICD-10/HEDIS/Stars

EMR systems

MS Office

Communication

Independent work

75% travel

Driver's license

Education

CPC/CPC-A certification

CRC certification

Tools

MS Office

EMR systems

Job description

UnitedHealth Group is seeking a Healthcare Advocate for field-based work in Saint Louis, MO. You will partner with physicians, medical groups, IPAs and hospitals to improve documentation and coding for Medicare Advantage, Medicaid, and ACA programs, driving RAF performance and quality outcomes.

Requires 2+ years in medical settings, ICD-10/HEDIS/Stars experience, and EMR proficiency. 75% travel and MS Office skills are essential for success in this role.