Hcc Risk Adjustment Coding Jobs in Houston, TX (NOW HIRING)

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40 locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.  

Kelsey-Seybold Managed Care Analytics exists to monitor and improve the financial performance of Kelsey-Seybold (KS) by providing actionable, data-driven insights to the organization. Within Managed Care Analytics, the Healthcare Economics team's primary focus is to perform quantitative analytics of utilization and healthcare cost data to identify opportunities for medical cost improvement and alternative contracting strategies.

The Healthcare Economics Director will oversee analytic functions supporting both Kelsey-Seybold's health plans and provider group risk contracts. The Director will own the end-to-end analytics and reporting processes related to medical cost and utilization trends. The Director will be a "hands-on" leader who will build out expertise on the team, leveraging data and analytics capabilities, and collaborate with internal and external stakeholders to examine medical cost trends.  Their team will also assess the impact of cost reduction initiatives and their effect on reducing short- and long-term medical cost spend.
 

Primary Responsibilities:

• Provides long-range planning and oversight of healthcare economics teams and functions to ensure activities are appropriately integrated into the strategic direction, as well as the mission and values of the company
• Accountable for the development, production, and analysis of reports and data required to understand the key drivers of the relevant business unit or service line including revenue, utilization, cost trend analysis, and initiative impact
• Recruiting and developing a team of analysts
• Participating as a key member in strategy discussions and meetings with the KS executive team
   

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:

• 10 years of experience in data analytics, actuarial services, underwriting, or a related field inclusive of:
• 8 years of experience supervising or managing teams and/or projects
• 3 years of programming experience in SQL, SAS, Python or similar programming language
• Demonstrated knowledge of trend analysis
• Advanced proficiency in Microsoft Excel
• Basic knowledge of Microsoft Power Point and Microsoft Word
• Fluent in English both verbal and written, effective communicator
• High level of accuracy with excellent attention detail
• Solid organizational and time management skills
• Proven ability to work in a dynamic setting and balance multiple priorities while meeting deadlines
• Superior analytical skills
• Ability to communicate complex information in a clear and concise manner
• Ability to motivate others and function as a working manager
   

Preferred Qualifications:

• Systems experience (i.e. enrollment/eligibility, capitation, claims payment, etc.) with an MCO.
• Experience with reporting and visualization tools (including Crystal Reports, Microsoft Access, and Power BI)
• Demonstrated knowledge of CMS HCC model and Risk Adjustment calculations
• Demonstrated knowledge of medical insurance products
• Familiarity with EPIC and Clarity reporting data warehouse
   

*All employees working remotely 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 salary for this role will range from $134,600 - $230,800 annually 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.

OptumCare 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.

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