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Clinical Claims Review RN, Lead - LHI - Telecommute

Company: UnitedHealth Group
Location: La Crosse
Posted on: January 6, 2022

Job Description:

At -Optum, the mission is clear: - Help people live heathier lives and help make the health system work better for everyone.
LHI -is one of 4 businesses under -OptumServe. -OptumServe -provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well - being of Americans. - -By joining -OptumServe -you are part of the family of companies that make -UnitedHealth Group -a leader across most major segments in the U.S. health care system.
LHI -was founded in 1999 and acquired by -Optum -in 2011, -LHI -specializes in creating and managing health care programs through on - location services, patient - specific in - clinic appointments, telehealth assessments, or any combination based on customer need. -LHI's -customizable solutions serve the diverse needs of commercial customers, as well as federal and state agencies, including the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services.
There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Ready for a new path? Start doing - your life's best work. (sm)
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
The hours for this position are Monday through Friday, 12pm - 9pmCST, including a weekend rotation.
***Weekend Rotation - -every 8-12 weeks and is a full-weekend rotation. You will be able to flex days during the week to account for those weekend days as well. ***
Primary Responsibilities:
Assist Clinical Operations Leadership Team in monitoring of all daily tasks completed within the Clinical Operations Department
Provide guidance to staff in electronic processing of medical information in an internal database
Perform QA of various medical services
Assist front line staff with bringing ideas for process improvements to leadership
Cultivate a positive environment while supporting team member growth
Evaluate and process medical information for various service types
Ongoing communication within Clinical Operations Department and other LHI departments to ensure exams are received from practitioners and processed in a timely manner
Communicate with a diverse group of people/disciplines while serving as a point of contact (POC) for internal and external entities
Monitor, manage and prioritize all Clinical Operations order related tasks for this role to facilitate controlled workflow to meet or exceed contractual requirements
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Associate's degree in Nursing program with an RN licensure in your state of residence, OR Foreign Medical Graduate, OR MSW or LPC from an accredited university
Understanding of regulatory standards and their application to various medical examinations and documents
Equivalent combination of education, experience and/or applicable military experience will be considered
Proficient use of computers
Database experience
Analytical thinking and teamwork skills
Must be able to problem solve in a fast paced environment, multitask and meet tight deadlines
Ability to perform detailed work with a high degree of accuracy
Full 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.
Preferred Qualifications:
Minimum of 4 years of experience in a medical/surgical environment
Occupational health and behavioral health experience
Must possess excellent verbal and written communication skills
Previous leadership experience
Military background
Knowledge of CPT and ICD10 coding
Experience reporting statistical data
National Career Readiness Certificate
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. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. 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. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $25.63 to $45.72. The salary range for Connecticut / Nevada residents is $28.27 to $50.29. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer 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.
UnitedHealth Group -is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: -Supervisor, Lead, Team Lead, Leadership, Clinical Operations, Quality Assurance, QA, Clinical Review, Electronic Medical Records, Medical, Surgical, Med/Surg, Occupational Health, OT, Behavioral Health, Military, CPT, ICD10. ICD-10, Telecommute, Work from Home #RPO

Keywords: UnitedHealth Group, La Crosse , Clinical Claims Review RN, Lead - LHI - Telecommute, Healthcare , La Crosse, Wisconsin

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