LosAngelesRecruiter Since 2001
the smart solution for Los Angeles jobs

Manager, CHAPs

Company: Optum
Location: Chatsworth
Posted on: January 16, 2022

Job Description:

OVERVIEW OF POSITION:Responsible for the ongoing development, implementation, and facilitation of processes to assure that all pertinent clinical information impacting the risk scoring of Medicare patients is captured and transmitted to health plans. Includes participation in ongoing data mining and analysis, oversight of physician reviewers and the review program, development and delivery of education and identification of opportunities to improve reimbursement through proper coding and documentation at the direction of the Regional Director. Oversees the general organization and efficient management of the Medicare Risk Adjustment activities and teammates in the region.ESSENTIAL FUNCTIONS:Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal and external customerCollaborates with regional management on key physician activities and Provider Relations and IPA liaisons on risk adjustment activitiesInteracts closely with central management by collaborating on development of regional programs and disseminating, managing, and overseeing central initiatives and data reporting to key stakeholdersInterprets and provides feedback on CMS regulations and HCC risk adjustments reimbursement methodologyEnsures dissemination of clinical/reimbursement information to all key stakeholdersActs as a resource on topics related to the clinical component of Medicare billing and Hierarchical Condition Coding in partnership with the regional risk adjustment clinician leadsIdentifies educational needs and meets these needs using both internal and external resourcesCollaborates in identifying targets for improvement and evaluates the results of interventionsHelps to identify further opportunities for diagnosis evaluationAssists in evaluating effectiveness of each activity associated with the programReviews and evaluates team performance for productivity and inter-rater reliabilityAssists in setting priorities for regional risk adjustment teamCoordinates the orientation of new teammates -including Advanced Care Practitioners (ACPs) in collaboration with the Regional DirectorOversees coordination of physician offices and embedded ACP schedulesMonitors embedded APC productivity and reimbursement.Works with Provider Relations department to facilitate dissemination of information to providersTracks and facilitates PCP payments related to special incentives implemented by the leadership teamMonitors ACP productivity and quality / productivity incentivesOversees quality of work provided by administrative support staffParticipates in process improvement projects related to work performedOrients new staff and provides training to teammates on work processesPerforms additional duties as assignedEDUCATION:Bachelor's degree from a four-year college and/or a professional certification requiring formal education beyond a two-year collegeMaster's degree preferredEXPERIENCE:Minimum:3 to 5 years experience in project management, health informatics, operations, and/or Medicare billingKNOWLEDGE, SKILLS, ABILITIES:Strong clinical background with both acute care and chronic disease state management experienceStrong Information Technology backgroundProficient user of MS Office Suite including intermediate to high-end user of Microsoft Access and ExcelStrong understanding of the principles governing healthcare reimbursement including ICD-10 / CPT codingExcellent organizational, critical thinking, and problem-solving skillsExcellent verbal and written communication skillsAbility to effectively interface with staff, clinicians and managementAbility to effectively manage a small team of medical assistants, outreach coordinators, and project coordinatorFull COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you'll find incredible ideas in one incredible company and a singular opportunity to do your life's best work. (SM)Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: Optum, Los Angeles , Manager, CHAPs, Executive , Chatsworth, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Los Angeles RSS job feeds