Risk Adjustment Analyst - Medicare Financial Analytics - Santa Ana, CA

Position Description:

Some people take things as they come. Others relentlessly push
themselves to go farther. Combine health care and technology, which are two of
the fastest-growing fields on the planet, with UnitedHealth Group's culture of
performance, collaboration and opportunity and this is what you get:
industry-leading health care services at a company that's improving the lives
of millions. The work is as challenging as it is rewarding. You'll open doors
to new opportunities. This is where bold people with big ideas are writing the
next chapter in health care. Join us. There's never been a better time to do your
life's best work.(sm)

The Risk Adjustment Analyst will be responsible for analyzing
Medicare risk adjustment data and forecasting change in revenue and risk adjustment
scores with a focus on specific programs performed by Optum for its clients.
Must have good written and verbal communication skills and be able to work well
with a team. Needs to have excellent time management and multitasking
skills and be able to work under the pressure of multiple deadlines. Will need
to enjoy thinking outside of the box and continually consider new ideas and
methodologies in an effort to refine forecast and projection models. This
position works within a team and the ideal candidate can be relied upon to
perform his/her own functions and also feel comfortable relying on others.

 

Primary Responsibilities:

• Data analysis


• Evaluating risk & opportunities


• Participation in client relationships


• Designing and running complex data programs


• Performing both standard and ad hoc processes


• Responsibilities may also include calculation of
  reserves, development of program rates and forecasting/trend analysis


• Coordinate with internal business units to perform data
  reconciliation and ensure integrity of the data for operations to conduct
  audits


• Perform financial and claim analysis at provider level


• Analyze trends and audit validation rate for
  programs/services provided by Optum


• Evaluating financial impact and scenario analysis of
  retrospective and prospective operations