Risk Adjustment, Associate Director Healthcare Economics - Remote

UnitedHealth Group•Plymouth, MN

15d•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. As the Optum Health 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. Our current major initiatives focus on standardizing and centralizing forecasting processes for Medicare Advantage Risk Adjustment across all markets with a focus on enhancing data quality, accelerating forecast production, and improving alignment with Finance and Accounting partners. We are internal analytics partners who provide expertise to our finance, operations, accounting, and clinical leads to forecast, reconcile, and analyze revenue and risk. If you eat, breathe, and sleep forecasting like we do—or if you’re driven, collaborative, and eager to learn—this is the place for you. As an Associate Healthcare Economics Director, you will be responsible for guiding the development and rollout of standardized forecasts, overseeing data transitions, mentoring analysts, and serving as a trusted partner to both market and national stakeholders. You will also work closely with data engineering teams to shape intake processes and ensure forecast-ready data pipelines. The role requires expert knowledge of CMS Medicare Advantage payment models, strong SQL and Excel skills, and experience working with large, complex healthcare datasets—preferably in Snowflake or similar modern platforms. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you lead critical components of this enterprise initiative. 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.

Requirements

Bachelor's degree in Mathematics, Statistics, Economics, Finance, or a related field
5+ years of healthcare analytics or forecasting experience, with 2+ years in a lead or strategic role
Demonstrated experience using CMS Medicare Advantage data files, including MMR, MOR, and MAO-004, in support of forecasting, reconciliation, or program performance analysis
Advanced to expert proficiency in SQL, with demonstrated experience managing large datasets
Advanced Microsoft Excel skills (e.g., complex formulas, modeling, automation)
Solid understanding of CMS Medicare Advantage Risk Adjustment models and their application to revenue forecasting
Proven ability to lead complex analytic projects and coordinate across functional teams

Nice To Haves

Master's degree in Mathematics, Statistics, Economics, Finance, or a related field
Experience building and deploying forecasting models in a healthcare payer or provider setting
Expertise in interpreting MMR and MOR reports, identifying discrepancies in MAO-004 submissions, and integrating these into financial or operational reporting
Experience building logic for forecast reconciliation using CMS payment and encounter data files
Familiarity with data infrastructure and ingestion pipelines, especially in Snowflake
Experience leading teams or mentoring junior analysts
Skilled in presenting technical concepts to executive audiences
Solid project management and documentation skills

Responsibilities

Serve as forecasting lead for multiple regions or sub-CDOs, owning model development and revenue delivery
Oversee forecast intake, development, and review processes, ensuring accuracy and consistency across markets
Collaborate with data engineering, finance, and operations partners to align data sources, forecast methodologies, and delivery timelines
Contribute to the design and implementation of centralized forecast infrastructure within platforms like Snowflake
Guide junior team members and analysts by providing mentorship, review, and technical direction
Translate complex analyses into actionable insights for executives and cross-functional teams
Ensure alignment with CMS risk adjustment methodologies, regulatory guidance, and industry best practices
Present forecasts, insights, and recommendations to senior leadership and national stakeholders