Optum is an international leader dedicated to enhancing healthcare through innovative technology, improving the lives of millions. Join our dynamic team to make a meaningful impact on health outcomes by effectively connecting individuals with essential care, pharmacy benefits, and vital resources. Here, you’ll discover a workplace culture anchored in diversity and inclusion, surrounded by skilled colleagues, and supported by comprehensive benefits and career advancement opportunities. Together, we can drive health equity on a global scale. Step into a role where you can truly make a difference— join us to start Caring. Connecting. Growing together.

In this pivotal role, you will oversee Optum360’s coding services, managing facility-based and/or Health Information Management (HIM) Center operations within your designated region. As a Subject Matter Expert (SME), you will spearhead significant initiatives related to quality metrics, workflow enhancements, and auditing processes to ensure we not only meet but exceed our performance goals. You will be instrumental in fostering efficient coding services and implementing best practices across facilities. This position involves direct engagement with clients, partnering with Quality Teams, Clinical Documentation Improvement (CDI) specialists, and other stakeholders to navigate pre-bill reviews, such as HAC/PSIs. Your commitment to continuous quality improvement will help us enhance business objectives while exceeding Service Level Agreement (SLA) expectations. Building strong client relationships and embodying the Optum360 values will be essential to your success.

Enjoy the freedom of working remotely from anywhere in the U.S. while tackling complex challenges.

Key Responsibilities:

• Maintain expert-level knowledge in coding practices to ensure the highest standards of accuracy and efficiency across all coding operations, both domestically and globally.
• Drive consensus for system and process standardization while coordinating effective change management and issue resolution within coding operations.
• Collaborate with HIM, CDI, and Coding Operations teams to oversee daily operations, conduct pre-bill coding, and quality reviews.
• Aid Coding Leadership in initiating and supervising processes aimed at continuous quality and efficiency improvements.
• Ensure that high-performance standards are met by upholding expertise in coding, contributing to corrective action plans, and implementing training as needed.
• Serve as the primary liaison between coding operations and clients, facilitating strong relationships and communication.
• Utilize analytics tools to monitor employee engagement and implement initiatives to boost satisfaction and productivity.
• Lead by example, creating a collaborative and transparent work environment that achieves optimum results.
• Actively participate in, and potentially lead, leadership forums and educational sessions for HIM/CDI managers.
• Support a successful business model by fostering team dynamics, delivering staff training, and providing constructive feedback aimed at professional development.
• Address other responsibilities as assigned by Optum360 leadership, including managing special projects, resource allocation, and task execution.
• Stay informed on applicable regulations and organizational policies, ensuring compliance and promoting a culture focused on service.

What You’ll Gain:

Join a collaborative environment where your efforts will be recognized and rewarded as you face new challenges with clear guidance and opportunities for growth into future roles.

Required Qualifications:

• A current, active coding credential from AAPC or AHIMA.
• A minimum of 5 years of experience in a coding reviewer capacity, with a focus on auditing Inpatient DRG accounts.
• Proven collaborative experience working with CDI and Quality leadership to enhance coding accuracy and reimbursement processes.
• Familiarity with computer-assisted coding technologies and EMR coding workflows.
• Proficient in Microsoft Excel for handling large datasets.
• Skilled in PowerPoint for effective training presentations across diverse audiences.

Preferred Qualifications:

• Experience with Cloudmed.
• Understanding of healthcare-related regulations at federal and state levels and regulations from accreditation bodies (e.g., CMS, TJC).
• Strong ability to influence organizational change and serve as a change agent.
• Exceptional organizational skills, capable of multitasking and managing multiple projects efficiently.
• Experience interacting with various stakeholders, including corporate, regional, local teams, external auditors, and consultants.
• Characterized by integrity and care, demonstrating the ability to inspire and motivate others while aligning with Optum360’s mission and values.

Remote employees are expected to adhere to UnitedHealth Group’s Telecommuter Policy.

The salary range for this role is between $71,600 and $140,600 annually for full-time employment. Compensation is influenced by local labor markets, educational background, work experience, certifications, and more. UnitedHealth Group adheres to all applicable minimum wage laws. Additionally, we offer a robust benefits package, including incentive programs, stock purchase options, and 401k contributions, ensuring a wide range of choices for employee benefits.

Application Deadline: This position will remain open for a minimum of 2 business days or until we find a suitable candidate. The job posting may close early based on applicant volume.

At UnitedHealth Group, our mission is clear: to empower individuals to live healthier lives while optimizing the health system for everyone. We acknowledge that substantial barriers to good health remain, especially affecting marginalized communities. Our commitment extends to creating equitable care solutions and alleviating health disparities.

UnitedHealth Group is an Equal Employment Opportunity employer. Qualified applicants will be considered for employment regardless of race, national origin, religion, age, gender, sexuality, disability, veteran status, or any other characteristic protected by law.