Risk Adjustment, Manager Healthcare Economics - Remote

Manager Healthcare Economics

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. 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 Manager Healthcare Economics, 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 advanced 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 :

• Lead a region and / or markets for forecasting revenue and collaborate with finance and accounting teams
• 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

Required Qualifications :

Preferred Qualifications :

The salary for this role will range from $89,800 to $160,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.