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Internship Optum Health Coding Risk Adjustment Jobs in Chicago, IL

Bcbsa

Medicare Plan Management Principal

Chicago, IL · Hybrid

... healthcare program expertise, stakeholder influence, and the ability to translate complex program requirements - spanning Star Ratings, Risk Adjustment, and Medical Cost Management - into clear ...

3B Staffing LLC

Coding Compliance Auditor

Chicago, IL · Remote

$28 - $32/hr

... risk, drive corrective action, and serve as a trusted resource on coding and compliance across the ... Bachelor's degree in Health Information Technology, Healthcare Administration, Nursing, or a ...

3B Staffing LLC

Coding Compliance Auditor

Chicago, IL · Remote

$28 - $32/hr

... risk, drive corrective action, and serve as a trusted resource on coding and compliance across the ... Bachelor's degree in Health Information Technology, Healthcare Administration, Nursing, or a ...

Deloitte

Medicaid Actuarial Senior Manager

Chicago, IL · On-site

Experience with risk adjustment mechanisms * Experience with Provider reimbursement streams (i.e ... Experience with health care reform and working knowledge of the individual medical and small group ...

NorthShore

Senior Coding Educator

Skokie, IL · On-site

$32.60 - $48.90/hr

... CMS) risk areas. Reads the OIG's Semi-Annual reports and the OIG'S/CMS's Annual Workplan, in ... Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, or related ...

Deloitte

Medicaid Actuarial Senior Manager

Chicago, IL · On-site

Experience with risk adjustment mechanisms * Experience with Provider reimbursement streams (i.e., DSH, UPL, etc.) * Experience with health care reform and working knowledge of the individual medical ...

3B Staffing LLC

Data System Analyst

Chicago, IL · Remote

... risk adjustment data, alongside internal systems such as EMR , CRM, HR etc. to maintain a reliable single source of truth supporting value based care. The ideal candidate will combine strong health ...

Deloitte

Medicaid Actuarial Manager

Chicago, IL · On-site

Experience with risk adjustment mechanisms * Experience with Provider reimbursement streams (i.e., DSH, UPL, etc.) * Experience with health care reform and working knowledge of the individual medical ...

3B Staffing LLC

Data System Analyst

Chicago, IL · Remote

... risk adjustment data, alongside internal systems such as EMR , CRM, HR etc. to maintain a reliable single source of truth supporting value based care. The ideal candidate will combine strong health ...

Deloitte

Actuarial Consultant

Chicago, IL · On-site

... risk adjustment * Support business development efforts for Federal and State governments, employer groups, and other public entities * Participate in the transformation of the health care sector ...

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All JobsOptum Health Coding Risk Adjustment JobsInternship Optum Health Coding Risk Adjustment JobsInternship Optum Health Coding Risk Adjustment Jobs in Chicago, IL

Internship Optum Health Coding Risk Adjustment information

What is the difference between Internship Optum Health Coding Risk Adjustment vs Medical Coding Specialist?

AspectInternship Optum Health Coding Risk AdjustmentMedical Coding Specialist
CertificationsTypically none or basic coding certificationsCertified Professional Coder (CPC) or equivalent often required
Work EnvironmentInternship setting, training-focused, healthcare companyHealthcare facilities, outpatient clinics, or insurance companies
Employer & IndustryOptum Health, healthcare and insurance industryHospitals, clinics, insurance providers
Search & Comparison IntentEntry-level, training, risk adjustment codingProfessional coding, billing, compliance

Internship Optum Health Coding Risk Adjustment roles are typically entry-level, training-focused positions within Optum Health, emphasizing risk adjustment coding with minimal certifications. Medical Coding Specialists are more experienced professionals with certifications like CPC, working in healthcare facilities or insurance companies. The internship provides foundational exposure, while the specialist role involves independent coding and billing tasks.

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Medicare Plan Management Principal

Bcbsa

Chicago, IL • Hybrid

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 23 hours ago

Job description

The role leads the design and execution of plan-facing strategy for the Medicare Advantage program. This leadership role serves as the primary architect of how BCBSA engages, educates, and activates BCBS Plans participating in the national MA program - translating national program strategy into actionable, plan-level initiatives that drive adoption, performance improvement, and sustained operational alignment.
The role will build and steward the full lifecycle of plan relations: from go-to-market planning and communications design, through change management execution and capability building, to ongoing engagement frameworks that hold plans accountable and support their success. This role requires a rare blend of strategic vision, healthcare program expertise, stakeholder influence, and the ability to translate complex program requirements - spanning Star Ratings, Risk Adjustment, and Medical Cost Management - into clear, compelling guidance that Plans can act on.
  • Serve as the primary relationship owner between BCBSA and the Plans for the national Medicare Advantage program by liaising with Plan contacts, ensuring satisfaction, aligning business processes with strategic goals, overseeing strategy sessions, policy development, and performance metrics, approving budget activities, updating stakeholders, coordinating support teams, and assessing technological efficiencies. Develop and own the annual go-to-market strategy for plan engagement, nuanced for Plan-tier differentiation. Lead the design of Plan participation structures and accountability mechanisms tied to governance.
  • Represent BCBSA in Plan-facing forums and facilitate constructive dialogue. Lead change manage strategy for program evolution, ensuring Plans are prepared for, engaged with and supported through operational, regulatory and strategic transitions.
  • Design and manage a comprehensive plan communications architecture -including regular reporting cadences, performance updates, policy notifications, and strategic briefings. Ensure clear and efficient communication with Plans and stakeholders. Build and maintain a plan-facing resource library-including playbooks, reference guides, training, and self-service tools. Promptly address Plan issues, offering support and information as needed. Oversee issue resolution with comprehensive accountability. Relay Plan intelligence summaries to senior leadership. Support BOM/BOD governance processes by preparing plan-facing communications and briefing materials to contextualize performance outcomes and program expectations.
  • Oversee approval of Plans' administrative cost budgets, ensuring adherence to Federal contract limits and managing annual variations in costs.
  • Lead and manage a team with the aim of driving effective performance management, fostering professional growth, and creating a positive and inclusive work environment. This role is dedicated to utilizing strong leadership and communication skills to motivate and inspire team members, ensuring they are aligned with and committed to achieving the organization's goals.

The posting range for this position is:

141,980.27 - 192,006.76


Qualifications:
Education

  • Required BS in Business Administration or other business discipline or equivalent work experience

Experience

  • Required 10+ Years of experience in healthcare strategy, managed care, or health plan operations, with at least 3 years in a leadership level role


Knowledge Skills and Abilities

  • Essential understanding of FEHBP, including its structure, regulations, and operations for effective management.
  • Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure highly desirable.
  • Adaptability to FEHBP changes and strategy adjustments as well as adaptability to Medicare Advantage regulatory changes, CMS policy updates, and FEP MA program strategy adjustments in a first-of-its-kind program environment.
  • Proficiency in Microsoft Windows, Word, and PowerPoint for communication and presentations.
  • Leadership skills to build, motivate, and manage teams, fostering collaboration and resolving conflicts.
  • Strategic alignment of team efforts to achieve objectives and results.
  • Independent decision-making skills for complex situations.
  • Skilled negotiation with external stakeholders like BCBS Plans to maintain positive relationships.
  • Effective presentation skills for clear and engaging communication to various audience sizes.
  • Ability to gain external customers' understanding and buy-in through compelling presentations.
  • Excellent organizational skills for administrative tasks, budgeting, and timeline management.
  • Meticulous attention to detail for accuracy, CMS program compliance, and FEP MA governance accountability.


Extra Posting Information:

#LI-Hybrid

The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate's position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.This job is also eligible for annual bonus incentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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