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UnitedHealth Group Sr Healthcare Economics Consultant (Risk Adjustment Analytics) - Telecommute in California

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 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 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.

You’ll enjoy the flexibility to telecommute* 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 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

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:

  • Degree in Economics, Statistics, Finance, Health Administration, Mathematics or related field and 3+ years of advanced analytics experience

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • 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)

  • 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

  • Strong analytical expertise: data analysis, statistical analysis, data manipulation, data extraction, and reporting

  • Excellent written and verbal communication skills with the ability to communicate effectively with leaders across the organization and external customers

  • 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

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

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. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*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.

Job Keywords: risk, data modeling, CMS, SQL, SAS