Job Description

The CIN Team Lead role is responsible for front line supervision of the Quality Coordinator, Administrative Coordinator and HCC Coding teams. This oversight includes collaboration with the CIN Care Management Team Lead and other CIN Leaders to ensure that NCQA case management and all applicable quality and coding standards are upheld. This role is primarily responsible for the daily business processes, productivity, training and day to day supervision of these groups. They are also responsible for the overall growth and development of the team(s) that they support with CIN Leadership oversight.

Primary Responsibilities:

* Supervises and is accountable for the daily activities of the CIN Quality Coordinator, Administrative Coordinator and HCC Coding roles. Due to the diversity of this team, these duties will vary based upon business needs. Anticipated duties include meeting daily and weekly requirements related to CM case assignment, HCC Action plan delivery, timely patient, clinic and PBM level communications while also meeting & supporting any required NCQA case management or quality standards
* Demonstrates a thorough understanding of customer service and is able to coach and mentor team to the same
* Able to articulate the differences and similarities between all plans and payers
* Works in a positive and collaborative fashion with colleagues, leadership and business partners
* Identifies and resolves operational problems using defined processes, expertise and judgment
* Makes informed decisions to support HCC coding, quality and business process management activities that are guided by team policies, NCQA standards, organizational best practices and contractual obligations
* Support and lead onboarding and new hire training for all new members of the CIN Team
* Develop insights into team performance and individual opportunities
* Perform audits as required to ensure compliance with required activities
* In conjunction with the manager, create an individual development plan and annual goals. Discussions on both of these topics should occur monthly and as needed
* Partners with leadership to provide weekly (first 90 days) or monthly feedback to Team members in 1:1 meetings
* Serve as initial point of contact for any escalated issues or concerns
* Recognizes opportunities to make the program scalable by identifying opportunities for continuous quality improvement related to all Team functions, training, business processes and workflow
* Supports Team growth with participation towards interviewing, hiring and retaining top talent
* Develops and refines professional communication of these teams with both internal and external customers
* Is responsible for creating and managing the guideline documents for each role or manuals that guide day to day work, and identify standards as well as best practice for each business process
* Collaborates with CIN leadership to develop scorecards for performance for each of these roles Performs other duties as assigned

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:

* Experience with HCC Coding, Managed Care, HEDIS and Medicare ACO Quality Measures
* Proficient with Microsoft office
* Familiarity with EMRs
* Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

* Experience working from home
* Project Management experience
* Customer Service Experience

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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: NCQA, HCC Coding, Managed Care, HEDIS and Medicare ACO Quality Measures, Dallas, TX, Texas