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Clinical Healthcare Risk Adjustment Consultant - Telecommute

UnitedHealth Group

Eden Prairie, MN
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Job Details

741933 Clinical Healthcare Risk Adjustment Consultant Telecommute

Clinical Healthcare Risk Adjustment Consultant - Telecommute (741933)

Position Description

What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. You'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting.


The Clinical Healthcare Risk Adjustment Manager will be responsible for the management and delivery of internal and client facing projects across various functional areas and /or organizations.  This person serves as a subject matter expert and must have experience with risk adjustment strategy or operations, and needs to be able to work effectively with all levels of management internally and in a client facing role with major, national health plans and provider organizations across Medicare, Medicaid and Commercial lines of business.


You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • Support design and development of Risk Adjustment Consulting Practice and services
  • Support Go to Market and delivery of Risk Adjustment Consulting Practice services to health plan and provider clients both within a team and as an individual contributor
  • Manage all aspects of medium to large-scale internal and external (client facing) priority projects, including managing resources, budget, and client deliverables
  • Act as a change advocate using strong collaboration and influencing skills across diverse business segments and geographies
  • Drive for results, anticipating customer needs and / or risks and proactively develop solutions
  • Recognize gaps between current situation and desired outcome and utilize appropriate resources to obtain information, consider solutions and deliver the solution
  • Cultivate innovative approaches to solve complex problems including conceptual analysis and development of innovative solutions
  • Translate highly complex concepts in ways that can be understood by a variety of audiences
  • Create written and oral communication materials that effectively summarize project status or other supporting activities including analysis findings and fact based recommendations
  • Conduct project management using industry-standard methodologies, with ability to adapt to company-specific tools and techniques

Required Qualifications:

  • Certified professional risk adjustment coder
  • Extensive experience with Risk Adjustment and Medicare regulations
  • Strong collaboration, negotiation, and influencing skills
  • Able to take initiative and work independently in a fast paced environment
  • Excellent time management, organizational, and prioritization skills
  • Demonstrated ability to communicate ideas clearly and concisely with all levels of the organization
  • Strong interpersonal skills to influence and spur cultural change, facilitate and enhance performance within a cross functional environment
  • 60% travel

Preferred Qualifications:

  • Bachelor’s degree
  • 5+ years of experience in project management with a proven ability to build relationships at all levels in the organization and drive results in a matrix environment with a high degree of change, growth, and ambiguity
  • PMP certification
  • Registered Nurse
  • Quality, HEDIS, and/or STARS experience
  • Experience working risk adjustment programs in providers’ offices
  • Experience with Risk Adjustment Data Validation (RADV) audits

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy



Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.


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



Job Keywords: Risk Adjustment, Consultant, Consulting, Project Management, PMP, RADV, NP, Nurse Practitioner, Healthcare, Coder, Eden Prairie, MN, Minnesota, Work at Home, Remote, Telecommuter, Telecommuting, Telecommute, Optum Consulting

Job Details

  • Contest Number741933
  • Job TitleClinical Healthcare Risk Adjustment Consultant - Telecommute
  • Job FamilyOptumInsight Consulting
  • Business SegmentOptumInsight

Job Location Information

  • Eden Prairie, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelYes, 75 % of the Time
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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