Network Program Consultant - Remote

We need to output HTML fragment with sections: About the role (maybe intro), Responsibilities, Requirements (Qualifications), Skills, Benefits, Pay, Schedule. Must only include sections with real specific content. No placeholder. Must not repeat job title. Must not include Job ID. Must remove boilerplate, navigation, legal, EEO, etc. Must preserve all substantive info. We need to parse the posting. First paragraph: "Optum is a global organization..." That's about the company, maybe "About the role"? Actually "About the role" heading is for description of role. The intro could be considered "About the role". We'll put that as

About the role

then

with that text. Then "Primary Responsibilities" heading: list of responsibilities. Use

• . Then "You'll be rewarded..." maybe part of Benefits? Actually that's about rewards and recognition, could be part of Benefits or maybe separate. But we have Benefits section: we have "In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)." Also earlier: "Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities." That's also benefits. So we can combine. Pay: "The salary for this role will range from $72,800 - $130,000 annually based on full-time employment." Also "Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc." So we have pay info. Schedule: Not explicitly given. There's mention of remote flexibility for Nashville: "If you are located in Nashville, TN, you will have the flexibility to work remotely* as you take on some tough challenges." Also travel 75% of time. That's schedule? Could be schedule: remote flexibility, travel 75%. We'll include Schedule section with that. Requirements: Required Qualifications list. Also Preferred Qualifications list. Could combine into Requirements section with subheadings? But we only allowed headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. The spec says use those headings for sections. We can have both Requirements and Qualifications? Might be redundant. Probably we should use Requirements for required qualifications, and Qualifications for preferred? Or we could combine into Requirements and then have Skills separate. Let's interpret: Requirements = required qualifications. Qualifications = preferred qualifications? Skills = maybe specific skills like MS Office proficiency, etc. But we have many skill-like items in required and preferred. Could split: Required Qualifications under Requirements, Preferred Qualifications under Qualifications, and Skills maybe list of specific skills like MS Office, communication, etc. However we must not create sections with filler. We have content for each. Let's decide: - About the role: intro paragraph. - Responsibilities: list of responsibilities. - Requirements: Required Qualifications bullet list. - Qualifications: Preferred Qualifications bullet list. - Skills: maybe list of specific skills like MS Office proficiency, communication, etc. But many are already in required/preferred. Could still extract: "Intermediate level of proficiency in MS Office Excel, PowerPoint, Word with the ability to manipulate data, filter, create and present presentations", "Advanced proficiency in MS Office (Excel (Pivot tables, excel functions)", "Proven effective ability to communicate with multiple stakeholders", etc. Might be redundant but okay. - Benefits: culture, comprehensive benefits, incentive and recognition programs, equity stock purchase, 401k, remote flexibility? Actually remote flexibility is schedule. - Pay: salary range and factors. - Schedule: remote flexibility for Nashville, travel 75% of time. We must not include boilerplate like EEO, drug free workplace, etc. Remove those. Now craft HTML. We need to ensure we don't include headings with empty content. All sections have content. Let's extract precise text. About the role: combine first two paragraphs? The first paragraph: "Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. If you are located in Nashville, TN, you will have the flexibility to work remotely* as you take on some tough challenges." But the remote flexibility part maybe schedule. We'll keep it in About the role? Might be better to move remote flexibility to Schedule. However the instruction: include a section ONLY when posting has real, specific content for it. The remote flexibility is specific content for Schedule. So we should not include it in About the role. So we need to split: About the role excludes the remote flexibility sentence. Let's separate. Thus About the role: "Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together." Now Schedule: "If you are located in Nashville, TN, you will have the flexibility to work remotely* as you take on some tough challenges." plus travel 75% of time (from responsibilities). Actually travel 75% is in responsibilities. But schedule could include travel expectation. We'll include both. Now Responsibilities: list all bullet points from "Primary Responsibilities" until before "You'll be rewarded...". Let's extract list: - Functioning independently, travel across assigned territory to meet with providers to discuss Optum tools and programs focused on improving the quality of care for Medicare Advantage Members. - Will be out in the field 75% of time in defined territory with rare occasion of overnight travel - Utilizing data analysis, identify and target providers who would benefit from our coding, documentation and quality training and resources - Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and hospitals - Develop comprehensive, provider-specific plans to increase their RAF performance and improve their coding specificity - Manage end-to-end Risk and Quality Client Programs - Consult with provider groups on gaps in documentation and coding - Provide feedback on EMR/EHR systems where it is causing issues in meeting CMS standards of documentation and coding - Partner with a multi-disciplinary team to implement prospective programs as directed by Market Consultation leadership - Assists providers in understanding the Medicare quality program as well as CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding - Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding - Supports the providers by ensuring documentation supports the submission of relevant ICD -10 codes and CPT2 procedural information in accordance with national coding guidelines and appropriate reimbursement requirements - Provides ICD10 - HCC coding training to providers and appropriate office staff as needed - Develops and presents coding presentations and training to large and small groups of clinicians, practice managers and certified coders developing training to fit specific provider's needs - Delivers diagnosis coding tools to providers - Trains physicians and other staff regarding documentation, billing and coding and provides feedback to physicians regarding documentation practices - Provides measurable, actionable solutions to providers that will result in improved accuracy for documentation and coding practices - Collaborates with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts - Assist in collecting charts where necessary for analysis - Self-starter with the ability to work independently and remain on task; ability to prioritize and meet deadlines - Other duties, as assigned Now Requirements (Required Qualifications): - 2+ years of a healthcare background with medical terminology, familiarity of clinical issues - Intermediate level of proficiency in MS Office Excel, PowerPoint, Word with the ability to manipulate data, filter, create and present presentations - Must be able/willing to travel up to 75% of the time in the assigned territory across Central South Tennessee - Active, unrestricted driver's license and auto insurance - Access to reliable personal transportation to perform daily travel requirements Now Qualifications (Preferred Qualifications): - Certified Professional Coder / CPC-A; equivalent certifications acceptable - CRC certification - 3+ years of provider network management, physician contracting, healthcare consulting, and Medicare Advantage experience - 2+ years of clinic or hospital experience and/or managed care experience - 1+ years of experience with Hospital or provider office EMR - 1+ years of coding performed at a health care facility - Territory management experience - Experience in Risk Adjustment, HEDIS/Stars, and gap closure initiatives - Experience in management position in physician practice - Project management experience - Knowledge of billing/claims submission and other related actions - Advanced proficiency in MS Office (Excel (Pivot tables, excel functions) - Proven nursing background i.e. LPN, RN, BSN - Proven effective ability to communicate with multiple stakeholders at various levels and the ability to collaborate with cross functional teams - Demonstrated ability to take responsibility and is internally driven to accomplish goals and recognize what needs to be done to achieve goals - Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer - All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy (maybe this is more policy, but it's a requirement for remote workers; could be included in Requirements or Schedule? It's a policy, but we might keep it under Requirements? However it's not a qualification per se. Might be considered a requirement for remote workers. But we could drop as it's somewhat boilerplate? It's specific to remote work policy. Might keep under Requirements? But it's not a qualification. Might be better to omit as it's more policy. However the instruction: preserve ALL substantive information; do NOT invent or summarize away detail. So we should keep it. Where to place? Could be under Requirements as a bullet. Now Skills: we could list specific skills like MS Office proficiency, communication, etc. But many are already in required/preferred. To avoid duplication, maybe we can omit Skills section and put those under Requirements/Qualifications. However the spec allows us to use Skills heading if we have content. We could create Skills section with items like: "Intermediate level of proficiency in MS Office Excel, PowerPoint, Word", "Advanced proficiency in MS Office (Excel Pivot tables, excel functions)", "Proven effective ability to communicate with multiple stakeholders", "Ability to collaborate with cross functional teams", "Self-starter", etc. But that duplicates. Might be okay but could be considered redundant. The instruction: Prefer a few substantive sections over many thin ones. So better to not create Skills if we can incorporate into Requirements/Qualifications. So we will omit Skills section. Thus sections: About the role, Responsibilities, Requirements, Qualifications, Benefits, Pay, Schedule. Now Benefits: we have culture, comprehensive benefits, incentive and recognition programs, equity stock purchase, 401k contribution, career development opportunities. Also "Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities." That's benefits. Also "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." That's also benefits. Also "In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution