Vice President Hcc Risk Adjustment Coder Jobs in Houston, TX

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.

The Vice President, Managed Care Performance is accountable for the financial performance, analytics strategy, and economic outcomes of Kelsey-Seybold Clinic's risk-bearing and value-based care business. This role leads a multi-disciplinary organization spanning actuarial services, healthcare economics, risk adjustment, affordability (cost of care), payor performance and analytics enablement.

As a senior executive partner, the VP translates complex data into actionable strategy and ensures that analytic insights directly drive measurable improvements in total cost of care, revenue, and population health outcomes. The role integrates clinical, operational, and financial perspectives to deliver sustainable performance across Medicare Advantage and other risk-based models.

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:

• 12 years of progressive experience in healthcare economics, managed care analytics, actuarial services, or related field, including leadership accountability
• Direct experience owning or influencing total cost of care, medical cost trend, or financial performance in a risk-based or value-based care model
• Experience with actuarial and financial functions including forecasting, financial modeling, or cost trend analysis
• Experience driving cost of care reduction, affordability initiatives, or risk adjustment performance
• Experience within a managed care, health plan, or risk-bearing provider organization
• Advanced experience in healthcare data analytics and translating data into actionable insights
• Experience partnering with IT or data teams to support analytics and reporting
• Experience presenting insights to senior leadership and influencing decisions
• Experience developing or using KPIs, scorecards, or performance tracking frameworks
• Solid healthcare economics experience focused on medical cost drivers and trend mitigation
• Proven leadership experience managing analytics, actuarial, or healthcare economics teams
• Knowledge of payor performance, contract structures (e.g., capitation), and healthcare cost economics
• Demonstrated accountability for measurable financial or cost outcomes

Preferred Qualifications:

• Advanced quantitative or actuarial training (ASA/FSA, MS in Analytics, Public Health, or related discipline)
• Experience leading Medicare Advantage Bid Strategy and execution
• Experience managing large-scale payer contract portfolios
• Proven experience leading enterprise affordability and value-based care initiatives
• Experience partnering directly with payors on contract negotiation and rate development
• Experience building or modernizing enterprise analytics platforms
• Experience leading large, matrixed, multi-disciplinary teams
• Experience within Optum, UnitedHealthcare, or similar managed care environment
• Systems experience (i.e. enrollment/eligibility, capitation, claims payment, etc.) with an MCO
• Experience with Medicare Advantage
• Experience with Crystal reporting tools, SQL programming
• Deep knowledge of IBNR, reserves, and advanced financial modeling in risk-based environments
• Solid understanding of network economics and value-based contract design
• Familiarity with predictive modeling, population health analytics, or AI/ML in healthcare
• Demonstrated success improving medical cost trend across multiple lines of business

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 $159,300 - $273,200 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.