Senior Risk Adjustment Coding Nurse (Hybrid, FL)

UnitedHealth Group

Orlando (FL)

Hybrid

Confidential

Full time

5 days ago

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Benefits offered by this job

Benefits package

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Stock purchase plan

401k plan

Job summary

UnitedHealth Group seeks a Sr. Clinical Coding Nurse Consultant to drive Risk Adjustment improvement with providers and market teams. You will lead analyses, develop remediation plans, and create tools to capture data for RA goals. Collaboration across regions and DataRAP education efforts are essential.

The role requires nursing experience, RN licensure, CPC certification timing, and travel as needed to support markets within Florida and beyond.

Qualifications

Bachelor's degree in Nursing required and active RN license.
CPC certification or obtained within 9 months from hire date.
5+ years nursing experience in health care.
1+ years familiarity with ICD-10 codes.
Willingness to travel locally and non-locally.

Responsibilities

Develop and implement market business plans to motivate providers to improve Risk Adjustment metrics.
Analyze Risk Adjustment reporting including summaries and PDF/fax back reporting.
Serve as SME for Risk Adjustment activities within assigned markets.
Develop training and analytical materials for Risk Adjustment initiatives.
Oversee training delivery for Mega Groups via provider education sessions.
Lead regular business review meetings summarizing provider and market performance.
Evaluate provider group structures to identify improvement opportunities.
Collaborate with DataRAP leadership on special projects.