Field Healthcare Advocate: Coding & Quality Champion

UnitedHealth Group; Bethesda (MD); On-site; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive & recognition programs

Equity stock purchase & 401k

Job summary

UnitedHealth Group is seeking a Healthcare Advocate to serve as a strategic partner to physicians, clinics, and hospitals, driving accurate documentation and coding to reflect members' health status. The role involves extensive travel across the Maryland/DC region to engage providers in Optum tools and programs that improve Medicare Advantage quality.

You will educate providers on CMS-HCC Risk Adjustment, RAF performance, and coding guidelines, while partnering with multidisciplinary teams to

Qualifications

• 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.
• Demonstrated proficiency in MS Office (Excel, Word, PowerPoint) with ability to manipulate data, create documents, and deliver presentations.
• Demonstrated ability to identify automation opportunities and leverage AI to improve productivity and quality.
• Reside in the Maryland / Washington DC Regional Area to perform daily field travel requirements.
• Must be able/willing to travel approximately 80% of the time, this is a field-based position that required daily local state travel.
• Must have proof of a valid Driver's License, reliable transportation, and current auto insurance to perform daily local state travel.

Responsibilities

• 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.
• Collaborate with multidisciplinary teams to implement prospective programs as directed by leadership.
• Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing the importance of accurate chart documentation for proper reimbursement.
• Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and national standards.
• Deliver ICD-10 HCC coding training and develop tools for providers and office staff.
• Provide measurable, actionable solutions to improve documentation and coding accuracy.
• Partner with physicians, coders, and facility staff on Risk Adjustment and Quality education efforts.
• Assist in chart collection and analysis as needed.
• Demonstrated communication skills with ability to engage multiple stakeholders and collaborate across teams.
• Self-driven, goal-oriented, and able to work independently while prioritizing tasks and meeting deadlines.

Skills

Healthcare experience

EMR systems

ICD-10 knowledge

HEDIS & Stars familiarity

MS Office

Data analysis

Communication skills

Travel readiness

Tools

MS Excel

Job description

UnitedHealth Group is seeking a Healthcare Advocate to serve as a strategic partner to physicians, clinics, and hospitals, driving accurate documentation and coding to reflect members' health status. The role involves extensive travel across the Maryland/DC region to engage providers in Optum tools and programs that improve Medicare Advantage quality.

You will educate providers on CMS-HCC Risk Adjustment, RAF performance, and coding guidelines, while partnering with multidisciplinary teams to