Healthcare Data & Performance Analyst

Optum; San Diego (CA); Hybrid; USD 33,000 - 59,000; Full time

Benefits offered by this job

Paid Time Off + Holidays

Medical Plan options + HSA/HDHP

Dental, Vision, Life & AD&D Insurance

401(k) Savings Plan + Employee Stock购买

Education Reimbursement

Employee Discounts

Employee Assistance Program

Volunteer Benefits

Job summary

Optum is seeking a Performance Analyst in San Diego, CA for a hybrid role requiring initial onsite training. The incumbent will manage data related to physician networks and perform chart reviews to support diagnoses and quality codes within the Performance and Risk Adjustment team.

The role emphasizes reporting, improvement initiatives, and collaboration with health plans, providers, and internal teams. Strong CPT/ICD-10 knowledge and healthcare experience are essential.

Qualifications

• Coding certifications from AHIMA or AAPC.
• 2+ years of experience in the healthcare industry.
• 1+ years of experience working with CPT and ICD-10 codes and reading claims forms/reports.
• Access to reliable transportation and ability to come onsite to San Diego office, as needed.

Responsibilities

• Generates reports for department workflow, production, quality monitoring and performance improvement.
• Participates in formulating improvement initiatives/solutions and assists with execution.
• Reviews AWVs and other charts for HCC diagnoses and quality codes and processes them into tracking programs.
• Recommends training opportunities and participates in provider training as needed.
• Audits and interfaces with outside coding vendors.
• Participates in webinars, conferences and conducts research to stay abreast of IHA/NCQA/CMS requirements.
• Serves as the user expert for software systems.
• Audits software accuracy and participates in testing.
• Attends user meetings and reports systems issues to the vendor.
• Tracks and submits audit data for program compliance.

Skills

Coding certifications AHIMA or AAPC

Healthcare industry experience

CPT ICD-10 codes

Onsite attendance readiness

Job description

Optum is seeking a Performance Analyst in San Diego, CA for a hybrid role requiring initial onsite training. The incumbent will manage data related to physician networks and perform chart reviews to support diagnoses and quality codes within the Performance and Risk Adjustment team.

The role emphasizes reporting, improvement initiatives, and collaboration with health plans, providers, and internal teams. Strong CPT/ICD-10 knowledge and healthcare experience are essential.