Rn supervisor, cdi team

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

The Supervisor, Clinical Documentation Improvement & Risk Adjustment is a working supervisor responsible for coordinating and supervising the day-to-day operations of the Risk Adjustment/Clinical Documentation Improvement RN team while actively participating in clinical documentation and medical record review activities.

The Supervisor sets daily priorities, assigns and coordinates work, monitors workflow and performance, provides clinical and operational guidance, and supports staff development to ensure timely, accurate, and consistent completion of work.

In addition to supervisory responsibilities, the Supervisor conducts medical record reviews to support the complete and accurate capture of documented chronic conditions under HCC and other applicable risk adjustment models. The role reviews clinical information from EpicCare and available claims data, supports prospective and retrospective review activities, and helps ensure documentation and coding opportunities are clinically supported and consistent with established guidelines and standard work.

The Supervisor works collaboratively with Risk Adjustment leadership, clinicians, Coding, Analytics, and other operational partners to support quality, workflow consistency, provider education, and Optum Massachusetts risk adjustment initiatives.

Primary Responsibilities:

• Working Supervisor & Daily Operations
• Clinical Documentation & Medical Record Review
• Quality Assurance
• Performance & Workflow Management
• Staff Supervision & Development
• Collaboration & Provider Support

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:

• Undergraduate degree in Nursing or equivalent education and experience consistent with organizational requirements
• Current, unrestricted Registered Nurse (RN) license in the applicable state
• If CRC certification is not held at the time of hire, certification must be obtained within one year of employment
• 3+ years of clinical experience
• 3+ years of clinical experience working with chronic disease populations in an ambulatory and/or inpatient setting

Preferred Qualifications:

• Professional coding certification, CRC through AAPC
• Experience across multiple specialties and disease states
• Experience with clinical documentation, risk adjustment, medical record review, HCC programs, clinical auditing, or coding
• Previous supervisory, team lead, or demonstrated leadership experience

Knowledge, Skills & Competencies

• Solid clinical knowledge of chronic disease populations
• Knowledge of clinical documentation integrity and risk adjustment principles
• Working knowledge of HCC models and applicable CMS requirements
• Working knowledge of ICD-10-CM coding principles
• Solid medical record review and clinical validation skills
• Ability to conduct quality audits and provide constructive feedback
• Solid analytical and problem-solving skills
• Ability to prioritize and coordinate the work of a clinical team while maintaining hands-on responsibilities
• Solid written and verbal communication skills
• Ability to coach and develop staff
• Ability to collaborate effectively with clinicians, coding, analytics, operations, and leadership
• Solid electronic health record navigation skills
• Proficiency with Microsoft Office applications, including Excel

Working Supervisor Role

This is a working supervisor position that combines direct day-to-day supervision of the RN CDI/Risk Adjustment team with active participation in medical record review, quality assurance, clinical documentation activities, and risk adjustment workflows.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. 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). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.