From Home Optum Health Coding Risk Adjustment Jobs in Milwaukee, WI

Remote work environment with frequent onsite expectations across Southeast Wisconsin Area

Pay Range

Major Responsibilities:

• Directsandmonitorsthe Risk Management Programandall ofits data platformsto align with industry standards and ensure patient safety and quality of care.
• Partners with operational, site, and system executive and medical staff leadership to further risk reduction and patient safetyobjectives. Keepsappropriate managementand leadership informed ofregion and site-based issues; coordinates communication to site from system.
• Partners with senior and executive and medical staff leadership toidentifyandfacilitatedevelopment and implementation of risk reduction measures in all areas of healthcare operations.
• Directs and coordinates health outcomes, risk identification, loss prevention, and claims management to support patient care quality and address potential financial, physical, and reputational risks.Identifieshigh-risk areas and directs proactive risk assessments and mitigation strategies.
• Participates in site and system-level safety meetings and weekly risk huddles.
• Participates in strategizing the educational needs of the sites and system andidentifyingcontent experts and speakers to ensure quality content.
• Designs and directs the work of theassignedarea(s) of responsibility.Selects, coaches, and develops teams, settingobjectivesthat align withorganizationalstrategy to inspire and motivate the teams. Manages organizational talent through performance management, succession planning, and development. Designs and directs processes by which team and individual performance are recognized, feedback is consistently delivered, and performance is systematically improved.
• Develops and/or recommendsoperating andcapital budgets and controls expenditures within approved budgetobjectives.
• Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that people actions, and the actions of employees supervised,comply withthe policies, regulations, and laws applicable to the organization's business

Licensure, Registration, and/or Certification Required:

• Certified Professionalin PatientSafety (CPPS) designation issued by the Certification Board for Professionals in Patient Safety (CBPPS) needs to be obtained within 1 year, or
• Certified Professional in Health Care Risk Management designation issued by the American Hospital Association (AHA) needs to be obtained within 1 year, or
• Similar licenseor certification.

Experience Required:

• Bachelor'sdegree in healthcare administration or related fieldrequired.

Work Experience Required:

• Typically requires7years of experience in a system healthcare setting, experience with risk management, healthcare law, patientsafetyand quality that includes3years of management experience with projects, staff,budgetsand/or multiple risk management functions.

Knowledge, Skills & Abilities Required:

• Demonstrated abilityleadingcollaborative activities, chairingmeetingsand making presentations to physicians and executive leadership.
• Demonstrated ability to work and function in a complex corporate, system environment.
• Ability to communicate effectively with individuals of diverse backgrounds from all disciplines and levels of the organization. Must be comfortable and able toeffectively and compassionately communicate with patients, claimants, and family membersregardingdifficult topics.
• Strong decision-making and critical thinking skills.
• Strong ability to manage multiple teams of people and projects simultaneously.
• Must be proficient in Microsoft Office (Excel, Access,PowerPointand Word) orsimilar products.
• Demonstratedexpertisein statistical/data analysis, data presentation, organizational ability, and attention to detail.
• Demonstrated ability to draft comprehensive reports and memosregardingall areaspertaining tothe Risk function.

Physical Requirements and Working Conditions:

• Generally exposed to a normal office environment.
• Operates all equipment necessary to perform the job including computer use.
• Exposure toroad and weather hazards during job-related trips.
• Must be able to sit, stand, bend, and liftfrequentlythroughout workday.
• Must be able to walk sufficiently to coverentiretyof site/facility.
• Must have clear speech,hearingand vision.

Preferred Job Requirements

Preferred Education

• Master's Degree in health care administrationof related field preferred.

Preferred Experience

• Nursing or other clinical knowledge, background, and experience preferred.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.