Remote Optum Hcc Coding Jobs in Ohio (NOW HIRING)

Qualifications

• Master's degree or higher in Nursing or a related clinical field
• 2+ years of experience in any of the following:
  • Telemedicine Care
  • Minimum 2 years of telephone triage experience
  • Care Management
• Active clinical licensure — any of the following:
  • Nurse Practitioner (NP) – Ohio
  • Family Nurse Practitioner (FNP) – Ohio
• OR any of the following nationally recognized NP certifications:
  • Family Nurse Practitioner (FNP)
  • Nurse Practitioner (NP)
  • Gerontological Nurse Practitioner (GNP)

• 1+ years of Managed Care experience, especially with Medicaid or Dual Eligible (D‑SNP) populations
• Experience working in interdisciplinary care teams
• Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures
• Background in home‑based care, transitional care, or chronic disease management

Join our client's innovative healthcare team to deliver virtual, physician‑led care for medically complex Medicaid and Dual Eligible patients across Delaware. This role offers flexibility, autonomy, and the opportunity to help launch a new market focused on proactive, home‑based care that improves patient outcomes and reduces avoidable hospitalizations.

• Provide comprehensive care management for medically complex Medicaid and D‑SNP patients through telehealth and remote monitoring
• Collaborate with physicians, RNs, social workers, therapists, caregivers, PCPs, managed care organizations, and community partners
• Guide patients and caregivers through care transitions, including hospital‑to‑home coordination and advance care planning
• Support quality initiatives through accurate clinical documentation, including HCC coding, risk adjustment, and closure of STAR/HEDIS gaps
• Contribute to the development of care pathways, workflows, and best practices as the Delaware program expands
• Build strong, trusting relationships with patients, families, caregivers, and interdisciplinary team members

• Participate in a shared 24/7 clinical triage rotation to prevent avoidable emergency department visits and hospitalizations