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Optum · 3 days ago

Healthcare Advocate - Shreveport, LA

Shreveport, LA

Full-time

Hybrid

Entry, Mid Level

$73K/yr - $130K/yr

2+ years exp

Optum is focused on improving the flow of health data and information to create a more connected system. The Healthcare Advocate role serves as a strategic partner to healthcare providers, supporting accurate documentation and coding practices while driving performance in Risk Adjustment and Quality programs through education and collaboration.

EducationHealth CareMedicalPharmaceutical

Responsibilities

Act as a trusted advisor and strategic partner to providers and medical groups, assisting in accurate documentation and coding to reflect members' true health status

Travel independently across the assigned territory (approximately 80% field-based, with occasional overnight travel) to engage providers in Optum tools and programs that enhance quality of care for Medicare Advantage members

Responsible for gaining participation and deployment of Prospective Programs achieving business goals and metrics

Utilize data analysis to identify and target providers who would benefit from coding, documentation, and quality training resources

Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and Hospitals

Develop and implement comprehensive, provider-specific plans to improve RAF performance, coding specificity, and gap closure

Manage end-to-end Risk Adjustment and Quality programs, including In-Office Assessment initiatives

Consult with provider groups on documentation and coding gaps; provide actionable feedback to improve compliance with CMS standards

Offer guidance on EMR/EHR system issues impacting documentation and coding accuracy

Collaborate with multidisciplinary teams to implement prospective programs as directed by leadership

Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing the importance of accurate chart documentation for proper reimbursement

Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and national standards

Deliver ICD-10 HCC coding training and develop tools for providers and office staff

Provide measurable, actionable solutions to improve documentation and coding accuracy

Partner with physicians, coders, and facility staff on Risk Adjustment and Quality education efforts

Assist in chart collection and analysis as needed

Qualification

ICD-10HEDISRisk AdjustmentEMR systemsCPC certificationMS ExcelHealthcare consultingCommunication skillsProject management

Required

2+ years of experience in a physician office, clinic, hospital, or similar medical setting

2+ years of experience with ICD-10, HEDIS, and Stars programs

1+ years of experience with EMR systems

Proficiency in MS Office (Excel, Word, PowerPoint) with ability to manipulate data, create documents, and deliver presentations

Proven solid communication skills with ability to engage multiple stakeholders and collaborate across teams

Ability to be self-driven, goal-oriented, and able to work independently while prioritizing tasks and meeting deadlines

Ability to travel up to 75% within designated market

Current driver's license and access to reliable personal transportation

Reside in Louisiana

Preferred

Certified Professional Coder (CPC/CPC-A) or equivalent certification

CRC certification

2+ years of clinic/hospital or managed care experience

Nursing experience (LPN, RN, NP)

Advanced proficiency in MS Excel (pivot tables, advanced functions)

Experience in Risk Adjustment, HEDIS/Stars, and gap closure initiatives

Proven knowledge of billing, claims submission, and coding software

Project management experience

Experience in provider network management, physician contracting, healthcare consulting, Medicare Advantage sales, or pharmaceutical sales

Territory management experience

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Company

Optum

Glassdoor3.6

Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.

Founded in 2011

Eden Prairie, Minnesota, USA

10001+ employees