Risk Adjustment, Manager Healthcare Economics - Remote

UnitedHealth Group•Plymouth, MN

1d•Remote

About The Position

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. If you are located within the 30-minute commutable range to Minneapolis or Washington, D.C, you will be required to work in the office a minimum of four days per week.

Requirements

Degree in Economics, Statistics, Finance, Health Administration, Mathematics or related field and 3+ 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.
Proficient with MS Excel, including creating Macros, Pivot Tables, SUMIFS, SUMPRODUCT, and VLOOKUPs, etc.

Nice To Haves

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.
Experience with Snowflake.
Advanced to expert proficiency with SAS and/or other data manipulation and statistical tools.
Knowledge of CMS regulations and specifications regarding Medicare Advantage risk adjustment.

Responsibilities

Lead key efforts around risk score forecasting, revenue assessment, predictive suspecting, program evaluations, and strategic guidance related to Medicare Advantage Risk Adjustment.
Lead a region and/or markets for forecasting revenue and collaborating 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.