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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start
Caring. Connecting. Growing together.
As the Optum Care National Risk Adjustment Healthcare Economics Team, we support all risk adjustment efforts across our enterprise, primarily focused on Medicare Advantage Risk Modeling and Financial Forecasting. We are internal analytics partners who provide expertise to our finance, operations, accounting, and clinical leads to identify coding gaps, assess opportunity, forecast, and analyze risk. If you eat, breathe, and sleep risk adjustment like we do, then this is the right place for you! If you’re not a risk adjustment expert, but hungry, driven, and willing to learn, we will help you become one of the best-in-class experts in the field.
As a Senior Healthcare Economics Consultant, you will help lead key efforts around risk score forecasting, revenue assessment, predictive suspecting, program evaluations, and strategic guidance related to Medicare Advantage Risk Adjustment.
The role also requires knowledge of the CMS Medicare Advantage payment models, and expert knowledge of data access, construction, and manipulation of large datasets to support planned analyses, using SQL development or similar tools.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
- Assist in leading complex analytic projects leveraging data from multiple sources
- Understand and apply highly technical specifications to healthcare datasets
- Serve as key healthcare economics and analytics contact for local, regional, and national OptumCare leadership and key national finance and operations stakeholders
- Multitask, prioritize, adapt to change, work well under pressure in an entrepreneurial environment, meet deadlines, and manage a project from start to finish
- Develop full understanding of CMS guidelines and specifications as it relates to Medicare Advantage and Risk Adjustment
- Identify and implement appropriate analytic and forecasting methodologies
- Develop and manage advanced forecast models
- Design, produce and support development of dashboards and key performance indicator reports to meet customer requirements
- Leverage and coordinate enterprise-wide capabilities to meet business-specific needs
- Educate non-technical stakeholders on risk adjustment topics from the clinical, operational, and financial perspective
- Communicate results to relevant audiences, and seek and apply feedback into future iterations and new analytic development
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
- 3+ years of advanced analytics experience focused on healthcare data
- Knowledge of the CMS Risk Adjustment models and applicability as it relates to revenue cycle analytics and forecasting
- Analytical expertise in data analysis, statistical analysis, data manipulation, data extraction, and reporting
- Proficient with MS Excel, including creating Macros, Pivot Tables, SUMIFS, SUMPRODUCT, and VLOOKUPs, etc.
- Intermediate to Advanced SQL programming skills (data querying, manipulation and transformation, table creation, complex joins across multiple sources, subquery, indexing, and summary reporting)
Preferred Qualifications
- Experience in supporting finance and accounting partners through an analytics focused role, including forecasting techniques
- Experience in predictive modeling, data manipulation, reporting, and analysis
- Experience synthesizing analysis into actionable and easy to digest insights
- Experience with Snowflake cloud database
- Knowledge of CMS regulations and specifications regarding Medicare Advantage risk adjustment
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
