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

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Performance Analyst (2382285)

Performance Analyst - 2382285

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 startCaring. Connecting. Growing together.

Challenge can often be its own reward. But why settle for just being challenged when you can also be nurtured, mentored and supported in building an impact and fast paced career? With UnitedHealth Group you can have all of the above, everyday. Join us and you'll play a key role in managing data about the physicians and specialists who are part of our provider networks. This role will put you on a team of incredibly talented technology and business professionals. You'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to startCaring. Connecting. Growing together.

As aPerformance Analyst,you will be a member of the Performance and Risk Adjustment team. Conducts chart review to code for diagnoses and quality. Monitors performance and participate in improvement initiatives in conjunction with Provider Relations, health plans, and providers.

Location:

6760 Top Gun St. (Suite 201) San Diego, CA. This is a hybrid* role, requiring onsite training for about 3-4 weeks upon hire and onsite attendance about 1-2 times monthly. Candidate must reside in Southern California and be willing and able to travel to San Diego office.

Schedule:

4 10-hour shifts (Monday-Thursday, 6:30am-5pm PST)

If you live near San Diego, CA, you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

Primary 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 as needed to stay abreast of IHA/NCQA/CMS requirements
• Serves as the user expert for software systems
• Audits software accuracy from time to time and participates in testing
• Attends user meetings and reports systems issues to the vendor
• Tracks and submits audit data for program compliance
• Performs other duties as assigned

What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Coding certifications from either 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 the ability to come onsite to San Diego office, as needed

Preferred Qualifications:

• Based in San Diego, CA
• Knowledge of HEDIS
• Knowledge of managed care concepts and healthcare delivery systems
• Understanding of health insurance industry and products
• Solid computer literacy, including competence with database and spreadsheet programs
• Microsoft Office products familiarity
• Demonstrated ability to work with changing priorities and varying deadlines
• Proven excellent organizational and interpersonal skills
• Proven organized self-starter with good follow-through

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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.