Optum · 1 day ago
Healthcare Advocate - Field Based in Houston, TX
Houston, TX
Full-time
Onsite
Entry, Mid Level
$73K/yr - $130K/yr
2+ years expOptum is focused on improving the flow of health data and information to create a more connected healthcare system. The Healthcare Advocate serves as a strategic partner to healthcare providers, ensuring accurate documentation and coding practices to improve quality of care and drive performance in Risk Adjustment and Quality programs.
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Responsibilities
Act as a trusted advisor and strategic partner to providers and medical groups, assisting in accurate documentation and coding to reflect members' true health status
Travel independently across the assigned territory (approximately 80% field-based, with occasional overnight travel) to engage providers in Optum tools and programs that enhance quality of care for Medicare Advantage members
Responsible for gaining participation and deployment of Prospective Programs achieving business goals and metrics
Utilize data analysis to identify and target providers who would benefit from coding, documentation, and quality training resources
Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and Hospitals
Develop and implement comprehensive, provider-specific plans to improve RAF performance, coding specificity, and gap closure
Manage end-to-end Risk Adjustment and Quality programs, including In-Office Assessment initiatives
Consult with provider groups on documentation and coding gaps; provide actionable feedback to improve compliance with CMS standards
Offer guidance on EMR/EHR system issues impacting documentation and coding accuracy
Collaborate with multidisciplinary teams to implement prospective programs as directed by leadership
Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing the importance of accurate chart documentation for proper reimbursement
Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and national standards
Deliver ICD-10 HCC coding training and develop tools for providers and office staff
Provide measurable, actionable solutions to improve documentation and coding accuracy
Partner with physicians, coders, and facility staff on Risk Adjustment and Quality education efforts
Assist in chart collection and analysis as needed
Qualification
Required
2+ years of healthcare experience with solid knowledge of medical terminology and clinical issues
2+ years of proven knowledge of ICD-10, HEDIS, and Stars programs
1+ years of experience with EMR systems
Experience in a physician office, clinic, hospital, or similar medical setting
Proficiency in MS Office (Excel, Word, PowerPoint) with ability to manipulate data, create documents, and deliver presentations
Proven solid communication skills with ability to engage multiple stakeholders and collaborate across teams
Ability to be self-driven, goal-oriented, and to work independently while prioritizing tasks and meeting deadlines
Demonstrated ability and willingness to travel up to 80% within Houston and surrounding area
Driver's License and access reliable personal transportation
Reside in Houston or surrounding area
Preferred
Certified Professional Coder (CPC/CPC-A) or equivalent certification
CRC certification
2+ years of clinic/hospital or managed care experience
Nursing background (LPN, RN, NP)
Experience in Risk Adjustment, HEDIS/Stars, and gap closure initiatives
Project management experience
Experience in provider network management, physician contracting, healthcare consulting, Medicare Advantage sales, or pharmaceutical sales
Territory management experience
Advanced proficiency in MS Excel (pivot tables, advanced functions)
Proven knowledge of billing, claims submission, and coding software
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
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