1+ months

Manager, Risk Adjustment - Telecommute - 936325

Eden Prairie, MN 55344 Work Remotely
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  • Job Code
    936325

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

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As a Manager, Risk Adjustment you'll provide consulting services to strengthen and improve payor health care operations that result in stronger financial returns and improved population health management. You'll use your subject matter expertise in risk adjustment to provide strategic direction for meaningful performance improvement. In partnership with additional consulting staff, you will work closely with health plan clients to ensure their needs are captured, opportunities for improvement are identified and critical deliverables are executed.

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Youll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

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Primary Responsibilities:

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  • Serve as a subject matter expert for the business processes related to risk adjustment
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  • Evaluate the risk adjustment strategy and submission processes of clients to identify improvement opportunities
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  • Provide support and guidance on risk adjustment and clinical quality operations, accreditation, quality improvement initiatives
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  • Support root cause analysis and develop targeted interventions designed to improve clinical quality and risk adjustment outcomes
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  • Provide project management support for consulting engagements
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  • Provide consulting support for client engagements
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  • Assist in the development of written proposals and power point decks to support business development efforts
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  • Support business development/sales efforts by serving as a risk adjustment SME as part of client sales presentations and/or developing slide decks and written content to support RFP responses and client proposals
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Youll 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.

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Required Qualifications:

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  • 5+ years of health plan experience
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  • 3+ years of experience in leading health plan risk adjustment operations
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  • Experience working multiple concurrent projects and ability to track time allocated across projects
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  • Experience presenting findings and recommendations to internal and/or external stakeholders
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  • Experience with Microsoft applications, Teams, Excel PowerPoint, 365 and Word
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  • Ability to describe the differences between the CMS and HHS models for hierarchical condition categories (HCC)
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  • Ability to travel up to 60% time; out on Sunday/Monday with return home on Thursday (or shorter trips)
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • Undergraduate degree; Masters degree
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  • Certified Risk Adjustment Coder (CRC)
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  • Risk adjustment experience across multiple product lines (i.e., Medicare, Medicaid, ACA)
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  • Quality expertise (HEDIS, NCQA Accreditation, Star Ratings)
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Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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Colorado Residents Only: The salary range for Colorado residents is $94,500 to $171,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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, youll find a far-reaching choice of benefits and incentives.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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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.

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

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Job Keywords: Risk Adjustment, Health Plan, Coding, Quality, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote

Posted: 2021-06-21 Expires: 2021-08-19

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Manager, Risk Adjustment - Telecommute - 936325

UnitedHealth Group
Eden Prairie, MN 55344

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