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Salaried Optum Health Coding Risk Adjustment Jobs in Gary, IN

... Blue Health Intelligence (BHI), analytics platform partners, and the Blue System. The Hub is ... CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization ...

... Risk Adjustment, and Medical Cost Management - into clear, compelling guidance that Plans can act ... Required 10+ Years of experience in healthcare strategy, managed care, or health plan operations ...

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Salaried Optum Health Coding Risk Adjustment information

See Gary, IN salary details

$34.8K

$60.3K

$90.1K

How much do salaried optum health coding risk adjustment jobs pay per year?

As of Aug 25, 2026, the average yearly pay for salaried optum health coding risk adjustment in Gary, IN is $60,336.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,800.00 and $72,600.00 per year, depending on experience, location, and employer.

What is a salaried Optum Health coding risk adjustment specialist?

A Salaried Optum Health Coding Risk Adjustment specialist is a healthcare professional employed by Optum Health who reviews medical records and codes diagnoses to ensure accurate risk adjustment. Their work supports proper reimbursement for Medicare Advantage and other risk-based health plans by identifying and coding chronic conditions and other relevant diagnoses. These specialists use their knowledge of ICD-10-CM coding guidelines and risk adjustment methodologies to improve documentation and compliance. Being salaried means they are full-time employees rather than contractors, which often includes benefits and consistent work schedules. Their efforts help ensure health plans are funded appropriately based on the health status of their members.

What are the key skills and qualifications needed to thrive as a salaried Optum Health coding risk adjustment specialist?

To excel as a Salaried Optum Health Coding Risk Adjustment specialist, you need a thorough understanding of ICD-10 coding, risk adjustment models, and healthcare compliance, typically supported by a coding certification such as CPC or CRC. Familiarity with electronic health record (EHR) systems, coding software, and data analytics tools is essential. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately interpreting clinical documentation and collaborating with healthcare teams. These competencies ensure accurate risk adjustment coding, regulatory compliance, and optimal reimbursement for healthcare organizations.

What are some common challenges faced by professionals in the salaried Optum Health coding risk adjustment role, and how can they be addressed?

One common challenge in the Salaried Optum Health Coding Risk Adjustment role is staying updated with frequent changes in coding guidelines, payer requirements, and risk adjustment models. Additionally, ensuring high accuracy while reviewing complex patient records under tight deadlines can be demanding. To address these challenges, professionals should engage in ongoing education, leverage available training resources provided by Optum, and actively participate in team knowledge-sharing sessions. Collaborating closely with clinical documentation specialists and auditing teams also helps maintain compliance and improve coding quality.

What is the difference between Salaried Optum Health Coding Risk Adjustment vs Medical Coder?

AspectSalaried Optum Health Coding Risk AdjustmentMedical Coder
CertificationsCPH, CCS, or RHIT often preferredCPH, CCS, or RHIT typically required
Work EnvironmentHealthcare organizations, insurance companies, remote optionsHospitals, clinics, outpatient facilities
Job FocusRisk adjustment coding, reimbursement accuracyClinical documentation, coding for billing
Industry UsageHigh in health insurance and managed careCommon in healthcare facilities

While both roles involve medical coding, Salaried Optum Health Coding Risk Adjustment specialists focus on risk adjustment coding to support insurance reimbursements, often working in managed care environments. Medical Coders typically handle clinical documentation coding for billing purposes in healthcare facilities. The roles share certifications and require strong coding skills but differ in their primary focus and work settings.

What are popular job titles related to Salaried Optum Health Coding Risk Adjustment jobs in Gary, IN?

For Salaried Optum Health Coding Risk Adjustment jobs in Gary, IN, the most frequently searched job titles are:

What job categories do people searching Salaried Optum Health Coding Risk Adjustment jobs in Gary, IN look for?

The top searched job categories for Salaried Optum Health Coding Risk Adjustment jobs in Gary, IN are:

Lead Actuarial Analyst, MA Risk Adjustment

Chicago, IL • On-site

Strive Health
Health Care and Social Assistance • 501 - 1,000 employees

$99K - $124K/yr

Full-time

Medical

Re-posted 27 days ago


Job description

What You'll Do

We are seeking a Lead Actuarial Analyst, MA Risk Adjustment to join our high-performing, insights-driven team. You will play a critical role in evaluating financial performance, uncovering areas of opportunity, and use your 3+ actuarial exam progress to help translate complex data into actionable strategies. Your work will directly influence how Strive supports patients, clinicians, and markets in achieving both clinical and financial success. (This position is internally titled Lead Analyst, Risk Adjustment Analytics). We offer a competitive Actuarial Study Program designed to help you succeed, including exam fee support, study resources, and rewards for passing exams and achieving actuarial credentials.

Essential Functions 

  • Translate RA performance data into clear financial insights (i.e. revenue impact, payment accuracy, ROI, forecasting). 
  • Analyze CMS data to identify areas of opportunity to increase operational efficiency. 
  • Interpret trends, model scenarios, and assess program and policy impacts. 
  • Enable data-driven decisions by linking operational performance to enterprise financial outcomes. 
  • Perform end-to-end reconciliation from submissions to CMS acceptance, RAF leakage, and implement controls. 
  • Develop business cases to assess opportunity, determine target metrics, and provide data driven insights to support investment decisions (i.e. staffing, tech, etc.). 
  • Prepare and deliver clear and concise reports, presentations, and recommendations to senior leadership, illustrating the findings and implications of analyses conducted. 

Who You Are 

  • A highly analytical problem-solver with a strong sense of ownership and intellectual curiosity. 
  • Able to manage a high volume of recurring and ad hoc deliverables without compromising quality. 
  • Comfortable navigating ambiguity and bringing structure to complex problems. 
  • An exceptional communicator who can translate technical findings into actionable business recommendations. 

Qualifications 

  • 4+ years of experience in risk adjustment analytics. 
  • 4+ years of experience analyzing MMR, MOR, MAO-004 and medical claims data. 
  • 3+ actuarial exams passed. 
  • High degree of proficiency in Microsoft Excel and SQL.  
  • Experience with PBI, Redshift, dbt docs is a plus. 
  • Bachelor's degree in a quantitative or health-related field (e.g., Economics, Public Health, Statistics, Health Services Research, Math, Finance). 

Annual Salary Range: $99,000 - $124,000. This position is also eligible for a target annual bonus of 10%