Senior Project Analyst Medicare Risk Adjustment - Santa Ana, CA

Senior Project Analyst Medicare Risk Adjustment - Santa Ana, CA - 550173

Position Description

What makes your career greater with UnitedHealth Group? Advancement, access to data, variety of product lines, and rewards for delivering on our mission ensures you will always be challenged to do your best.


This position on the Revenue Projection team will work closely with multiple teams – Revenue Projection, RADV, and our clients. In addition to understanding the inventory and performing financial valuations, the Senior Project Analyst will be performing critical complex research and ad-hoc studies to assist Optum and our clients to understand Medicare coding trends. In this role you will need to understand our clients' objectives to better plan future enhancements to existing methodologies.  You will need to be extremely detail oriented but also to be able to analyze potential risks and to find ways to mitigate these risks.
Unique to this position is the ability to greatly impact the clients' revenue. Drivers of changes to clients' revenue could include providers over-coding or changes to coding practices. Revenue Projection needs to coordinate with RADV and our clients to evaluate the risks.
Additionally, this role will represent our clients in the deletes processing as well as being able to factor in program impact to providers' membership and revenue.  Finally, there will be analysis request that require short turn-around time and attention to compliance issues due to the regulated nature of Medicare.


  • Requirements:
  • Master's degree or Bachelor's degree with equivalent experience
  • Medicare Risk Adjustment, Medicaid, or Healthcare background is required
  • Experience calculating RAF scores strongly preferred
  • Statistics, Actuarial, Healthcare Analytics background is highly preferred
  • Trend analysis experience preferred
  • Familiarity with healthcare coding and compliance preferred
  • Intermediate level of proficiency with MS Excel
  • 2+ years of experience with SQL or SAS
  • Ability to understand and maintain relational databases
  • BI (Business Intelligence) reporting capabilities preferred
  • Great written and verbal communication skills
  • Detail-oriented and analytical aptitude


OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.


Keywords: client facing, team oriented, Medicare Risk Adjustment Project Manager, strong technical skills, analytics, RAF score, SAS, SQL, relational databases, MS Excel, Mediare Risk Adjustment Job, Analyst, Analysis


Job Details
Contest Number: 550173
Job Title: Senior Project Analyst Medicare Risk Adjustment - Santa Ana, CA
Job Family: Actuarial
Business Segment: Optum Shared Services
Job Location Information:
Region: North America
Country: United States
City: Santa Ana
State - Province: California
Other States where Job(s) is Located: ,,,,
Other Cities where job(s) is Located: ,,,,
Additional Job Detail Information:
Employee Status: Regular
Schedule: Full-time
Job Level: Individual Contributor
Shift: Day Job
Travel: No
Telecommuter Position: No
Overtime Status: Exempt