HealthMarkets Insurance Agency, Inc

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.. If you eat, breathe, and sleep risk adjustment like we do, then this is the right place for you!. 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.. Develop full understanding of CMS guidelines and specifications as it relates to Medicare Advantage and Risk Adjustment. Expert knowledge of CMS regulations and specifications regarding Medicare Advantage risk adjustment

risk adjustment

**COVID-19 VACCINATION REQUIREMENT UPDATE:** We have updated our COVID-19 policy for new and existing employees. Learn more *This policy applies to US/ US territory candidates and employees only:* 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. **Sr Healthcare Economics Consultant Risk Adjustment Analytics Telecommute**
Requisition Number: 2046789 Job Category: Healthcare Economics Primary Location: El Segundo, CA
(Remote considered)
**Clinical**
**your lifes best work.SM**
Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, youll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do **your lifes best work.SM**
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. 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 youre 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.
Youll enjoy the flexibility to telecommute* from anywhere within United States 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 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 seek and apply feedback into future iterations and new analytic development
Youll 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 3+ years of advanced analytics experience
* Solid analytical expertise: data analysis, statistical analysis, data manipulation, data extraction, and reporting
* Intermediate proficiency with SQL, SAS, and/or other data manipulation and statistical tools
* Proficient with MS Excel, including creating Macros, Pivot Tables, SUMIFS, SUMPRODUCT, and VLOOKUPs
**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
* Advanced to expert proficiency with SQL, SAS, and/or other data manipulation and statistical tools
* Expert knowledge of CMS regulations and specifications regarding Medicare Advantage risk adjustment
* Knowledge of healthcare administrative data (medical claims, enrollment, provider data)
* Excellent written and verbal communication skills with the ability to communicate effectively with leaders across the organization and external customers
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 candidat es 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 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. 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 el #J-18808-Ljbffr

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