Identify appropriate assignment of CPT and ICD 10 Codes for outpatient ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits Understand the Medicare Ambulatory Payment Classification (APC) codes Abstract additional

Designing, building and operating secure cloud platform services and software that meet business requirements Leading a team of cloud platform engineers to ensure technical solutions align with architectural principles, design patterns, and security requirements Innovate to improving efficiency, reducing technical drag, and create usable app patterns Practice SRE principl

Provide presentations and demonstrations to customers and prospects of our products after thorough discovery incorporating value statements and benefits to Physicians, Administrators, Clinical Staff and C Level Executives Provide staffing and participation in product areas for tradeshows and product fairs Strategize with the Sales Team on a strategy to win Provide trainin

Act as client lead on a day to day basis for delivery of large scale and complex projects Lead recurring meetings across finance, pharmacy, clinical, and actuarial client teams Collaborate with key stakeholders to identify and develop business questions for analytic investigation (e.g., utilization analysis) Develop and design complex data programs and forecast models, by

Leads and coordinates ongoing staff evaluation, retention, training and management of policies and procedures Interviews and hires staff Onboards, orients, and provides ongoing coaching, mentoring and support to staff. Models and teaches these skills to others Manages and oversees staff performance through performance planning and coaching Conducts annual evaluations and

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Oversight for overall MPP OPAS performance and achievement of contractual SLA goals Facilitate workflow for centralized resources, clinical & non clinical, who engage with onsite client clinical staff to deliver a streamlined UM process flow and best in class client experience for each individual MPP Lead and drive new Integrated Utilization Management and UM component of

Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department Utilize various resources such as third party publications, procedure manuals and participating contractual agreements, etc. to reconcile accounts Advanced knowledge and understanding to process third party rejections u

Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department Utilize various resources such as third party publications, procedure manuals and participating contractual agreements, etc. to reconcile accounts Advanced knowledge and understanding to process third party rejections u

Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For

Design, develop and implement analytics rules engines Research, evaluate, and deploy new tools, frameworks, and patterns to build sustainable Big Data platform Identify gaps and opportunities for improvement of existing solutions Define and develop APIs for integration with various data sources in the enterprise Analyze and define customer requirements Assist in defining

Lead the Case Management Operational teams for dedicated Optum client accounts for onsite delivery and outcomes. Accountable to meeting or exceeding operational and contract Service Level Agreements. Establishes and maintains service roadmaps to develop an integrated, innovative solution across all Care Management services. Provides input to consulting leadership for the

Escort Vendors such as Curvature, Hitachi/Dell, IBM, Cisco, Teradata, and others Protect Media Assets Oversee Dock Activity including sending and Receiving shipments & Pallets Be on time and ready to work consistently Keep documentation on what has transpired during tour of duty Represent the team and Optum with a can do attitude What are the reasons to consider working f

Manage day to day RCM A/R and cash application process striving for operational excellence. Aid in continually improving our cash flow/DSO through effective accounts receivable and collections Ensure overall RCM A/R and Cash App processes are operating effectively and continually improving our financial and operating controls Accountable for managing RCM financial activit