Sr Healthcare Economics Consultant – Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

 

We are seeking a strategic and detail-oriented Senior Healthcare Economic Consultant to lead advanced analytics and support client-facing engagements. This role is critical in identifying medical cost improvement opportunities, forecasting risk adjustment revenue, and developing data-driven strategies that enhance financial and quality performance for our clients.

 

The ideal candidate brings deep technical expertise in healthcare analytics, a solid understanding of risk adjustment and quality programs, and a consultative mindset to deliver high-impact insights and recommendations.

 

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

 

Primary Responsibilities: 

• Conduct in-depth quantitative analysis of utilization, cost, and member data to identify drivers of healthcare spend and cost of care improvement opportunities
• Develop and deliver advanced analytics including revenue development analysis, RAF calculations, submission reconciliation, and data leakage identification.
• Forecast risk adjustment revenue and identify coding or documentation gaps across client populations
• Translate complex data into executive-ready summaries, dashboards, and presentations
• Identify emerging trends in client data and collaborate with business analyst consultants to develop actionable strategies
• Serve as a subject matter expert in risk adjustment and quality analytics to guide program design and execution
• Design and maintain analytical models to estimate opportunity for cost savings, revenue maximization, and performance improvement
• Partner with actuarial, financial, and clinical teams to support cross-functional strategy development
• Develop and maintain reporting solutions and dashboards to monitor performance over time and benchmark against industry standards
• Support vendor oversight through analytical validation of suspecting and coding services
• Conduct root cause analyses of cost and coding variances and support remediation through data or operational fixes
• Stay current on CMS, HHS, and state regulatory updates related to risk adjustment, quality programs, and cost containment

 

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: 

• 3+ years of progressive experience in healthcare analytics, healthcare consulting, or payer/provider strategy
• Demonstrated experience with revenue forecasting and cost of care analysis
• Experience translating analytical findings into business strategy and operational recommendations
• Demonstrated proficiency in data visualization tools such as Tableau or Power BI
• Proven advanced skills in SQL and at least one statistical tool such as SAS, R, Python, or similar
• Demonstrated ability to synthesize large, complex datasets and distill into actionable insights

 

Preferred Qualifications:

• Actuarial or advanced analytics certification
• Experience supporting value-based care programs and provider alignment strategies
• Demonstrated working knowledge of risk adjustment models (Medicare Advantage, ACA, Medicaid) and quality frameworks (Stars, HEDIS, QRS)
• Familiarity with healthcare business drivers such as provider performance, utilization trends, and network incentives
• Proven excellent written and verbal communication skills, with ability to explain complex data to executive and non-technical audiences
• Demonstrated project management skills; ability to manage multiple priorities and deliverables
• Proven consultative mindset with a passion for problem-solving and continuous improvement
• Demonstrated ability to work independently and collaboratively in a fast-paced environment

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

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.   

 

 

UnitedHealth Group 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.

 

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