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. We are internal analytics partners who provide expertise to our finance, clinical operations, accounting and market teams 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 the knowledge and ability to access data, construct and manipulate large datasets to support planned analyses, use SQL, as well as the ability to visualize and present findings.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- 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 approaches and methodologies
- 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
- Communicate results to relevant audiences, 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.
- Degree in Economics, Statistics, Finance, Health Administration, Mathematics or related field and 3+ years of advanced analytics experience
- Strong analytical expertise: data analysis, statistical analysis, data manipulation, data extraction and reporting required
- Excellent written and verbal communication skills with the ability to communicate effectively with leaders across the organization and external customers
- Intermediate proficiency with SQL and/or other data manipulation and statistical tools
- You will be required to adhere to UnitedHealth Group’s US Telecommuting Policy
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
- Advanced to expert proficiency with SQL, SAS, and/or other data manipulation and statistical tools
- Advanced data visualization skills
- Experience synthesizing analysis into actionable and easy to digest insights
- Experience measuring impact and ROI of operational programs and services
- Expert Knowledge of CMS regulations and specifications in regards to Medicare Advantage risk adjustment
- Experience working with healthcare data
- Experience in predictive modeling, data manipulation, reporting, and analysis
- Knowledge of healthcare administrative data (medical claims, enrollment, provider data)
- Demonstrated capability in driving business result through modeling and segmentation implementation, analysis and refinement
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
Job Keywords: analytics, data analysis, statistical analysis, data manipulation, SQL, SAS, data visualization, CMS, healthcare data