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Job Details


UnitedHealth Group

Healthcare Economics Consultant - Risk Adjustment - Remote

Healthcare

Healthcare Network Director

No

Schaumburg, Illinois, United States

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and 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. We are internal analytics partners who provide expertise to our finance, operations, accounting and market teams to identify coding gaps, assess opportunity, forecast, and analyze risk. 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 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, SAS 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 approaches and methodologies
  • Develop and manage advanced forecast models
  • Design, produce, and support development of financial and operational 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 and incorporate results into forecasting process and reporting


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:

  • Undergraduate degree or equivalent experience
  • 3+ years of advanced analytics experience
  • Solid SQL skills and experience
  • Proficient with MS Excel, including creating Macros, Pivot Tables, SUMIFS, SUMPRODUCT, and VLOOKUPs

Preferred Qualifcations:

  • Bachelor’s degree in Economics, Statistics, Finance or Health Administration or related field
  • Experience in supporting finance and accounting partners through an analytics focused role, including forecasting techniques
  • Knowledge of CMS regulations and specifications regarding Medicare Advantage Risk Adjustment
  • Knowledge of healthcare administrative data (medical claims, enrollment, provider data)
  • Solid analytical expertise to include data analysis, statistical analysis, data manipulation, data extraction, and/or reporting


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination 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. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

Colorado, Connecticut, Nevada or New York City Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada / New York City residents is $72,800 to $129,900. 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.

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