Remote Senior Coding Ops SME - Quality & Compliance

UnitedHealth Group; Eden Prairie (MN); On-site; Confidential; Full time

Job summary

UnitedHealth Group seeks a senior Coding Operations SME to oversee Optum360 coding across facilities, ensuring quality, standardization, and client satisfaction. You will drive audits, CDI collaboration, and CAC/EMR optimization while maintaining strong internal and external relationships.

The role supports remote work from anywhere in the U.S., with responsibilities spanning leadership, training, and process improvements to exceed SLAs and KPI targets.

Qualifications

• High School Diploma or GED required.
• Current coding credential through AAPC or AHIMA.
• 5+ years as a coding leadership SME in large multi-site healthcare organizations.
• 5+ years coding reviewer experience auditing Inpatient and/or Outpatient accounts.
• 5+ years collaborating with CDI and Quality leadership.
• 5+ years experience with CAC tools and EMR.

Responsibilities

• Oversee Optum360 Coding operations across facilities and regions.
• Lead quality metrics, audits, and workflow improvement initiatives.
• Maintain client relationships and coordinate with CDI/Quality leadership.
• Mentor staff, provide training, and drive employee engagement.
• Lead leadership forums, cross-functional collaboration, and special projects.

Skills

Leadership

Coding audits

CDI collaboration

CAC/EMR

Excel

PowerPoint

Education

High School Diploma/GED

Tools

Microsoft Excel

Microsoft PowerPoint

EMR

Job description

UnitedHealth Group seeks a senior Coding Operations SME to oversee Optum360 coding across facilities, ensuring quality, standardization, and client satisfaction. You will drive audits, CDI collaboration, and CAC/EMR optimization while maintaining strong internal and external relationships.

The role supports remote work from anywhere in the U.S., with responsibilities spanning leadership, training, and process improvements to exceed SLAs and KPI targets.