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Job Details

UnitedHealth Group

Associate Healthcare Economics Director - Remote


Healthcare Network Director


Plymouth, Minnesota, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

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 an Associate Healthcare Economics Director, 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 expert 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 telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Advise and execute on the development and implementation of 'best in class' processes, tools, and capabilities to support financial forecasting and related analytics
  • Assist in leading and developing complex analytic projects leveraging data from multiple sources
  • Support production of clear and concise summaries of analytical findings for easy consumption by a variety of audiences through an assortment of media: presentations, email summaries, executive summaries, and verbal discussions
  • Support the operationalization of reporting and creation of flexible architecture that can support tremendous growth and evolving KPIs
  • 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:

  • Degree in Economics, Statistics, Finance, Health Administration, Mathematics or related field and 5+ 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
  • Advanced proficiency with SQL development
  • Advanced proficiency with MS Excel, including creating Macros, Pivot Tables, SUMIFS, SUMPRODUCT, and VLOOKUPs, etc.

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 measuring impact and ROI of operational programs and services
  • Knowledge of BI reporting software including Tableau, Power BI, or similar tools
  • Knowledge of CMS regulations and specifications regarding Medicare Advantage risk adjustment
  • Advanced to expert proficiency with SAS and/or other data manipulation and statistical tools
  • Excellent written and verbal communication skills with ability to communicate effectively with leaders across the organization and external partners

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

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, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $97,300 to $176,900. The salary range for Connecticut / Nevada residents is $97,300 to $176,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

*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.