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Internship Optum Health Coding Risk Adjustment Jobs in Elmhurst, IL

Northwestern Medicine

Coding Specialist II

Chicago, IL · On-site

$65 - $90/hr

Also demonstrates expertise to resolve Optum coding edits. RESPONSIBILITIES * Utilizes technical ... Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT ...

Northwestern Medicine

Coding Specialist II

Chicago, IL · On-site

This patient-first approach is what sets us apart as a leader in the healthcare industry. As an ... Also demonstrates expertise to resolve Optum coding edits. RESPONSIBILITIES Description * Utilizes ...

Guidehealth

Healthguide - Peer Support Specialist

Chicago, IL · On-site +1

$18 - $23.25/hr

Experience supporting value-based care, population health, care gap closure, quality performance, risk adjustment, or total cost of care initiatives. * Experience working with high-risk patient ...

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 ...

Endeavor Health

Senior Coding Educator

Skokie, IL

$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 ...

Endeavor Health

Senior Coding Educator

Skokie, IL

$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 ...

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All JobsOptum Health Coding Risk Adjustment JobsInternship Optum Health Coding Risk Adjustment JobsInternship Optum Health Coding Risk Adjustment Jobs in Elmhurst, 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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The most popular types of Optum Health Coding Risk Adjustment jobs in Elmhurst, IL are:

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Internship Optum Health Coding Risk Adjustment jobs near you

Sr. Associate, Medical Economics

Hopscotch Primary Care

Chicago, IL

$94K - $120K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 12 days ago

Key responsibilities

  • Support the build and maintenance of Hopscotch's cost categorization capability, including updates and change management.

  • Build and maintain the medical economics reporting suite and support analyses such as IBNR estimation, cohort forecasting, and paid-risk pacing.

  • Review monthly outputs to identify cost drivers and trends, analyze factors affecting medical costs, and collaborate with leadership to conduct high-impact analyses.

Job description

About Hopscotch Primary Care

At Hopscotch Primary Care, we believe great healthcare should be accessible to all people across all communities.  Today, almost 20% of Americans live in a rural community, yet only 11% of physicians practice in those same communities.  We are on a mission to transform healthcare in rural America.  We provide high-quality primary care tailored to meet the needs of our patients through our robust care model and comprehensive care team, delivering care in our clinics, and across settings, and wrapping resources around the patients who need them most.   

Our patients and the care teams who serve them sit at the center of everything we do at Hopscotch.  Hopscotch Primary Care takes a team approach to serve patient needs and provide the best care possible.  Our goal is to provide the care each of us would want for ourselves or for our family members, in the right setting, and at the right time. 

Today, we are serving thousands of patients in our value-based care model and the number is growing every day.  If you want to bring your experience, skill and passion to make a lasting impact in healthcare, we'd like to meet you. 

Role Description

The Sr. Associate, Medical Economics operates at the intersection of FP&A, analytics, and population health, turning claims and clinical data into the insight that drives Hopscotch's value-based care performance. Working on top of our engineering governed data foundation, this person will mature and maintain the standard claims model and the reporting infrastructure that underpins financial close, clinical review, and performance management. We're looking for someone equally strong at building the infrastructure and interrogating what comes out of it - technically excellent, with the judgement to know when a number is wrong and why.

Key Responsibilities

  • Support the in-house build of Hopscotch's cost categorization capability – including customizations, updates for new code and mappings, and change management.
  • Own the ongoing maintenance, enhancements, governance, change control, and documentation for Hopscotch's payer data and cost categorization capabilities.
  • Build and maintain the medical economics reporting suite (e.g., SQL, PBI, Excel) and support IBNR estimation, cohort forecasting, and paid-risk pacing.
  • Review monthly outputs to surface cost drivers and emerging trends, distinguishing real movement from the impact of incomplete claims and statistical noise.
  • Analyze medical cost trend across factors such as unit cost, utilization, mix; and enrich claims with EHR, eligibility, provider, and risk adjustment data to explain population-level trends and financial performance.
  • Work with medical economics and finance leadership to identify and complete high-impact analyses, including pro forma and ROI for medical cost initiatives.
  • Partner across Clinical, Operations, and Finance to translate business questions into analyses, ensure results flow accurately into management reporting, and build repeatable analytic processes that scale across programs.

About You

  • You build and you interrogate – you can stand up a clean dataset and tell when the output doesn't pass the smell test or is logically inconsistent.
  • You exercise critical thinking and understand the conceptual framework and database relationships that underly healthcare data.
  • You are comfortable with ambiguous problems and immature data and take pride in acknowledging what's unknown while taking steps to fill the gaps.
  • You form a point of view; you don't just produce the number, you explain what's driving it and why it matters.
  • You document as you build, so your definitions are transparent and others can rely on them. 
  • You're a self-starter with an ownership mindset, thrive in a fast-paced environment, and care about transforming rural healthcare.

Qualifications

  • Bachelor's in Economics, Finance, Statistics, Mathematics, Health Informatics, Actuarial Science, or a related quantitative field.
  • 3+ years of experience in healthcare analytics or medical economics (payer, provider, health system, ACO, or VBC).
  • High proficiency in SQL, Power BI, and Excel. 
  •  Hands-on experience with healthcare claims data, and combining data sources (claims, eligibility, EHR, risk adjustment).
  • Familiarity with healthcare financial and utilization concepts (e.g., PMPM, MLR, utilization per 1,000, trend, risk adjustment)
  • Experience with maturing data models, identifying improvement opportunities while still generating value from nascent datasets.
  • Experience presenting and communicating data-driven insights to functional leaders.

Preferred / Bonus 

  • Direct value-based care / medical-economics analytics experience, and familiarity with key considerations and leading methodologies for claims cost categorization.
  • Experience with Palantir Foundry or a comparable enterprise data platform.
  • Comfort using AI-assisted tooling to accelerate build and analysis.
  • Statistical methods (regression, difference-in-differences, propensity score matching).
  • Experience leading technical/analytical projects with combined teams of functional and technical stakeholders.

In accordance with the Illinois Pay Transparency Act, we're providing the full salary range for this position. Actual compensation will be determined based on location, relevant experience and qualifications. Most offers will fall within a portion of the listed range. This position has a salary range of $110,000 – $120,000 annually, based on location, relevant experience and qualifications. In addition to base salary, we offer a comprehensive benefits package that includes:

  • Paid holidays + PTO
  • Company sponsored medical, dental, and vision insurance for you + your family
  • FREE short-term and long-term disability insurance
  • FREE $100k life insurance policy
  • 401k plan with 4% company match + no vesting period
  • $720 - $1,000 added to employee Health Savings Account annually for eligible health plans
  • And more!

At Hopscotch Primary Care, we embrace diversity, invest in a culture of inclusion and positivity and encourage all to apply to join our team.  You will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.