Optum Health Coding Risk Adjustment Jobs in Dallas, GA

WHO IS GUIDEHEALTH? 

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. 

Join us as we put healthcare on a better path!!  

The Healthguide is a key member of Guidehealth's care delivery model, serving as a bridge between patients, their primary care physicians and specialty providers, community resources, and the Guidehealth clinical team. This role blends patient navigation with foundational clinical insight, helping patients overcome barriers to care, strengthening relationships with medical practices, coordinating resources, and supporting wholeperson health.

The Healthguide engages patients remotely and occasionally in person to help them understand their health needs, navigate medical and social systems, close gaps in care, and progress toward optimal health outcomes. In this position, you will support Guidehealth's mission to empower patients, reduce the cost of care, and promote efficient, compassionate healthcare delivery by leading with empathy.

The Healthguide contributes directly to value-based care performance by improving quality outcomes, reducing avoidable utilization, supporting risk adjustment accuracy, and influencing total cost of care.

WHAT YOU'LL BE DOING

• Building trusting, ongoing relationships with patients, families, caregivers, and medical and behavioral health providers.
• Engaging high-risk or targeted patient populations using bidirectional communication to address health questions, concerns, and care needs.
• Identifying and assessing medical, behavioral, social, emotional, and financial needs to support whole-person care.
• Supporting patients in understanding and following care plans, health goals, and preventive care needs, including providing education and motivational interviewing.
• Conducting nonclinical assessments, surveys, and interventions to help patients navigate medical, behavioral, and social systems.
• Utilizing effective communication methods, including calls, texts, video visits, patient portals, emails, and AI agents, to engage and support high-risk patients.
• Recognizing and escalating changes in patient condition, adherence risks, or emerging clinical concerns using structured workflows.
• Applying clinical insight to identify high-risk trends and prioritize interventions.
• Operating within a value-based care model, supporting population health strategies, quality performance, and efficient resource utilization across assigned patient panels.
• Strengthening the connection between patients and their healthcare providers by addressing barriers, facilitating communication, and coordinating follow-up.
• Assisting with referrals, transportation, appointment scheduling, and linkage to specialty care or community-based organizations.
• Utilizing knowledge of referral processes, prior authorizations, gaps in care, social determinants of health, and community programs to improve patient outcomes.
• Escalating medical issues appropriately to RN Care Managers, Social Workers, primary care provider offices, or Guidehealth leadership.
• Supporting the achievement of quality measures, including eCQM, HEDIS, and commercial payer measures, by coordinating preventive screenings, managing chronic conditions, and ensuring timely follow-up care.
• Supporting risk adjustment and the accurate capture of patient conditions through structured assessments and documentation.
• Assisting in closing care gaps tied to quality incentives and reimbursement models.
• Identifying opportunities to reduce avoidable emergency department visits, hospitalizations, and readmissions through proactive outreach and intervention.
• Accurately and promptly documenting all interactions, assessments, and interventions in the electronic health record and Guidehealth documentation systems.
• Demonstrating comfort using various electronic health record platforms, including Epic, Athena, and Cerner, as well as analytics tools and Microsoft Office.
• Managing referrals, tracking tasks, completing reconciliations, and maintaining detailed records according to Guidehealth policies.
• Supporting the design and implementation of artificial intelligence to conduct outreach to identified populations.

WHAT YOU'LL NEED FOR SUCCESS

• Must be fully bilingual in Arabic and English, including full medical terminology
• At least 2-3 years of related experience in patient navigation, medical assistance, health promotion, care coordination, or similar roles.
• Must hold a valid Medical Assistant Certification
• Experience working directly with patients in clinical or nonclinical settings, preferably with complex medical/social needs.
• Demonstrated experience with EHR documentation and remotework effectiveness.
• Performance of other duties as assigned.
• Compliance with all Guidehealth policies and procedures.

The salary range for this role is $21.00 to $23.00 per hour plus $1.50 per hour language differential.

ALIVE with Purpose: How We Thrive at Guidehealth 

At Guidehealth, our values come to life in everything we do. 

• We are Driven by Accountability - grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike. 
• Always Growing, Always Learning - staying curious and continuously improving inspires us to shape a better future for healthcare. 
• With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve. 
• At Guidehealth, Every Voice Matters - we believe our collective strength is rooted in the unique perspectives of each team member. 
• And through Empathy in Action, we build stronger connections with those who count on us. 
• This is what it means to be ALIVE with purpose. This is how we thrive - together - at Guidehealth. 

BENEFITS:

While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
• Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
• Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
• Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.

All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits.

COMPENSATION:

The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT 

Diversity, inclusion, and belonging are at the core of Guidehealth's values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. 

OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA

This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth's custodianship as well as Guidehealth Intellectual Properties.  For any security-specific roles, the responsibilities would be further defined by the hiring manager. 

As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements.

REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements. 

SECONDARY EMPLOYMENT

At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest. 

To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.