Sr Healthcare Economics Consultant, MA Risk Adjustment - Remote

Lensa; Houston (TX); Remote; USD 89,000 - 177,000; Full time

Job summary

Lensa seeks a Senior Healthcare Economics Consultant for UnitedHealth Group, focusing on Medicare Advantage risk adjustment. This fully remote role involves leading complex analytics projects and requires extensive knowledge of healthcare data and CMS guidelines. Join a culture aimed at improving health outcomes through innovative analytics.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Qualifications

• 3+ years advanced analytics experience in healthcare data.
• Expertise in CMS regulations for Medicare Advantage.
• Intermediate SQL skills and proficiency in MS Excel.

Responsibilities

• Lead analytics projects spanning multiple healthcare data sources.
• Develop and manage advanced forecast models for risk adjustment.
• Educate stakeholders on risk adjustment topics and analytics.

Skills

Data Analysis

Statistical Analysis

Data Manipulation

Data Extraction

Tools

SQL

MS Excel

Snowflake

Job description

Sr Healthcare Economics Consultant, MA Risk Adjustment - Remote

Sr Healthcare Economics Consultant, MA Risk Adjustment - Remote

1 day ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking professionals. Apply via Lensa today!

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 Care 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. We are internal analytics partners who provide expertise to our finance, operations, accounting, and clinical leads 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.

The role also requires experience in CMS Medicare Advantage payment models, and expert knowledge of data access, construction, and manipulation of large datasets to support planned analyses, using SQL development or similar tools.

You’ll enjoy the flexibility to work remotely * 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
• Possess a full understanding of CMS guidelines and specifications as it relates to Medicare Advantage and Risk Adjustment
• Identify and implement appropriate analytic and forecasting 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
• Educate non-technical stakeholders on risk adjustment topics from the clinical, operational, and financial perspective
• 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

• 3+ years of advanced analytics experience focused on healthcare data
• Experience in CMS regulations and specifications regarding Medicare Advantage risk adjustment, revenue cycle analytics and forecasting
• Analytical expertise in data analysis, statistical analysis, data manipulation, data extraction, and reporting
• Proficient with MS Excel, including creating Macros, Pivot Tables, SUMIFS, SUMPRODUCT, and VLOOKUPs, etc.
• Intermediate SQL programming skills (data querying, manipulation and transformation, table creation, complex joins across multiple sources, subquery, indexing, and summary reporting)
  
  

Preferred Qualifications

• 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
• Experience with Snowflake cloud database
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
  
  

The salary range for this role is $89,800 to $176,700 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.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  IT Services and IT Consulting

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