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Senior Financial Analyst - Minnetonka, MN

UnitedHealth Group

Minnetonka, MN
Job Code:
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Job Details

Senior Financial Analyst - Minnetonka, MN(Job Number:713181)

The Sr. Financial Analyst will develop expert knowledge of the CMS-HCC and RxHCC risk adjustment model, its concepts and methodology in order to reconcile CMS risk score reports, project future revenue related to risk adjustment and evaluate financial impacts of risk adjustment initiatives. In addition to ensuring the accuracy, quality and integrity of the data, this person will perform detailed and complex analyses in order to evaluate risk score trends. This position will be responsible for managing projects related to systems/technical solutions, requirements gathering and documentation, and troubleshooting and resolution. The ideal candidate for this position will be proficient in SAS or SQL and have a strong analytic experience; additionally, they need to be results oriented and willing to do whatever it takes to manage a project to completion.


Primary Responsibilities:

  • Validate RxHCC risk adjustment extract logic, which includes oversight of logic programmed within internal systems based on CMS rules and guidelines

  • Monitor CMS changes to the RxHCC risk adjustment process and calculate any corresponding impacts

  • Provides short range trouble shooting for day to day issues and ongoing maintenance with the RxHCC risk adjustment applications and reporting

  • Makes recommendations as needed to ensure reliability of the process and finds innovative solutions if problems should occur

  • Provides encounter data reconciliation between CMS and health plan claims detail to ensure accurate RxHCC risk adjustment payments

  • Ensures that the CMS return files received either directly from CMS or from the health plan or their intermediary are reconciled to the submitted files

  • Develops policies and procedures for system, application and related operational processes in order to ensure optimization and compliance with CMS RxHCC risk adjustment guidelines

  • Maintains RxHCC risk adjustment data base for complex analytics

  • Analyze, review, forecast, and trend complex data

  • Review the analysis and interpretation of others work

  • Present analysis and interpretation for operational and business review and planning

  • Develop ad-hoc and standard operational reports

  • Support short and long term operational/strategic business activities through analysis

  • Develop and implement effective/strategic business solutions through research and analysis of data and business processes

  • Document/Communicate root causes affecting performance as identified through analysis

  • Determine and track financial implications of initiatives

  • Document/communicate key milestones for effective strategy execution



Job Financial Planning & Analysis
Primary Location US-MN-Minnetonka
Other Location US-Minnesota
Organization M&R Finance
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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