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Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Network Program Consultant - Remote - **Company:** Unitedhealth Group Inc - **Location:** Nashville, TN, United States (Remote available) - **Salary:** $72,800.0 - $130,000.0 - **Contract:** Permanent contract - **Skills:** Microsoft Word, Microsoft Excel, Data Analysis, Excel Formulas, Healthcare Effectiveness Data and Information Set, Microsoft Office, Network Administration, Pivot Tables, Microsoft PowerPoint, EHR Systems - **Published:** September 4, 2026 - **Apply:** https://www.nashvillejobsite.com/job.asp?id=3377297339&tx=FK7976FFQ&pt=1&aff=0B19D771-A501-4A5E-8338-2A822B784D54&utm_source=Job%20Feed&utm_medium=textkernel&utm_campaign=DE&utm_term=0B19D771-A501-4A5E-8338-2A822B784D54 ## About the Role * 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, * 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 ## Description * 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 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. ## Related Videos - [Why Your Next Best Talent Might Not Be in Your Neighborhood](https://www.wearedevelopers.com/videos/1861-why-your-next-best-talent-might-not-be-in-your-neighborhood) - [Data Science in Retail](https://www.wearedevelopers.com/videos/586-data-science-in-retail) - [Bitcoin SV: The Massively Scaled Blockchain to Meet Developer Needs](https://www.wearedevelopers.com/videos/20-bitcoin-sv-the-massively-scaled-blockchain-to-meet-developer-needs) - [Beyond Dashboards: Fixing Text-to-SQL with Semantic RAG](https://www.wearedevelopers.com/videos/2036-beyond-dashboards-fixing-text-to-sql-with-semantic-rag) - [Beyond the 9–5: Designing Work Around Humans](https://www.wearedevelopers.com/videos/1321-beyond-the-9-5-designing-work-around-humans) - [Data Science on Software Data](https://www.wearedevelopers.com/videos/162-data-science-on-software-data) ## Related Articles - [Best Paying Remote Jobs](https://www.wearedevelopers.com/magazine/255-best-paying-remote-jobs) - [Fully Remote Software Engineer Jobs](https://www.wearedevelopers.com/magazine/447-fully-remote-software-engineer-jobs) - [Best Job Boards for Remote Work for Developers](https://www.wearedevelopers.com/magazine/290-best-job-boards-for-remote-work-for-developers) - [Mastering Remote Work: Tips for Developers](https://www.wearedevelopers.com/magazine/558-mastering-remote-work-tips-for-developers) - [The Best Job Search Websites of 2025](https://www.wearedevelopers.com/magazine/368-the-best-job-search-websites-of-2025) - [Remote Work: Best Practices for Developers](https://www.wearedevelopers.com/magazine/315-remote-work-best-practices-for-developers)