Medicare Consultant - MCAIP
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About The Position
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. The Medicare Consultant provides specialized expertise in risk adjustment coding, supporting provider clients and collaborating closely with Practice Performance Managers to enhance quality performance reporting. This role engages with operational and clinical leadership to identify best practices in chronic condition assessment, clinical documentation, and accurate coding. The Consultant facilitates the implementation of programs that ensure diagnoses are properly documented and coded in compliance with CMS, CDC, and official risk adjustment guidelines. Additionally, the Consultant educates providers on CPT II coding requirements for the CMS Medicare Advantage Star Ratings program. Operating within a matrixed environment, this position receives direction from UHC M&R while reporting directly to Optum Insight.
