Associate Director of Risk Adjustment Programs - Remote

Davita Inc.; Brentwood (TN); Remote; USD 106,000 - 195,000; Full time

Job summary

A leading organization is seeking an experienced professional to manage risk adjustment programs and drive performance improvements. The role requires expertise in Medicare Advantage, strong data management skills, and collaboration with multiple stakeholders to enhance healthcare outcomes. This position offers flexibility for remote work and competitive compensation based on qualifications.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Flexible remote work options

Qualifications

• 5+ years of experience with Medicare Advantage Risk Adjustment programs.
• 2+ years working with electronic medical records.
• Experience analyzing complex clinical data.

Responsibilities

• Manage end-to-end data and program management of risk adjustment programs.
• Advise executive leadership on program performance and growth opportunities.
• Lead collaboration with cross-functional teams and stakeholders.

Skills

Data Management

Program Management

Clinical Data Analysis

Tools

MS Outlook

MS Word

MS Excel

MS PowerPoint

Job description

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.

Primary 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

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:

• 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

Preferred Qualification:

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

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary range for this role is $106,800 to $194,200 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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 eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.