Associate Director of Risk Adjustment Programs

UnitedHealth Group • Brentwood, TN

210d • $106,800 - $194,200 • Remote

About The Position

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. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

• 5+ years of experience with Medicare Advantage Risk Adjustment programs
• 5+ years of experience with risk adjustment documentation, coding and CMS submission standards
• 5+ years of experience manage programs with clinical suspect presentation to providers and diagnosis gap closure
• 5+ years of experience working with provider practices
• 2+ years working with electronic medical records and submission of bulk data, including CCDs, structured data files
• 2+ years of experience analyzing and interpreting complex clinical data and analytics reporting

Nice To Haves

• Proficiency with MS Outlook, Word, Excel, and PowerPoint

Responsibilities

• Responsible for end to end data and program management of risk adjustment programs including inventory management, incentives, and market initiatives
• Manage the execution of end-to-end risk adjustment program components including deployment, provider encounters, open/closed clinical suspects, coding, and submission
• Advise executive leadership on current performance, growth opportunities, and issues impacting program success
• Lead collaboration with cross-functional teams to establish communication, create job aids, engage with providers, vendors and internal teams, integrate new data sources, and align multiple stakeholders
• Cross functional relationship with Care Delivery Markets and Optum Health leadership providing updates to senior leadership with development of PowerPoint and data packages
• Partnering internally with business partners to drive strategic opportunities aligning to business objectives, goals and overall strategy
• Providing executive level program updates on MBO performance, stars and risk performance, department goals and mitigated action plans

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Industry: Insurance Carriers and Related Activities