Associate Director Actuarial Services – Remote – Minnetonka, MN Hybrid preferred

Requisition Number: 2286579
Job Category: Actuarial
Primary Location: Minnetonka, MN, US
(Remote considered)

Doctor consulting nurse at nurse station.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.  

 

This is who we are. Fortune 4. An acknowledged global leader in the rapidly evolving health care system. A company known for bold, innovative ideas and innovation. And here’s where you can help us go.  As an Associate Director Actuarial Services at UnitedHealth Group, you will be part of an elite team working on complex projects that have strategic importance to our mission of helping people lead healthier lives and to help the health system work better for everyone. It’s an opportunity to help rewrite the future of our company and health care itself.

 

Be part of a team that is accountable for the development and execution of analytical and reporting of risk adjustment data for Medicare Advantage Plans supporting all CMS payment models.  Work collaboratively with financial planning & analysis, actuarial, accounting, and office of the controller to ensure data collection and reporting of risk adjustment revenues meet the needs of all stakeholders and conforms to Centers for Medicare and Medicaid Services (CMS) regulatory requirements. 

 

Demonstrate expert knowledge of the CMS-HCC risk adjustment methodologies, including Medicare Advantage, Medicare Part D, and ESRD models; understand the impact of changes made by CMS on the models and educate stakeholders as needed.

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. This position is open to anyone who would work remotely in the U.S.  The preferred location for this position is our Minnetonka, MN office with a hybrid work schedule of  four in-office days per week.

 

Primary Responsibilities: 

  • Manage the Hierarchical Condition Category (HCC) revenue function to ensure accuracy of risk scores at the member level and translate data into actionable reporting
  • Develop monthly revenue accruals related to the risk adjustment activities and participate in annual budget process
  • Monitor risk adjustment submissions as compared to expected revenue and proactively address gaps in data submissions and impacts to forecasting and budgets
  • Analyze risk adjustment data in support of business decisions to prioritize member and provider outreach programs focused on capturing diagnosis codes  
  • As requested, provide analytics to support CMS risk adjustment data validation audits and other audits
  • Translate highly complex concepts in ways that can be understood by a variety of audiences
  • Development of new risk adjustment tools / analyses to expand UHC’s ability to predict risk scores and revenue using emerging data
  • Expand RAF program analytics to enhance valuations and potentially refine the operations of existing programs and/or introduction of new programs
  • Utilization of Medicare Advantage risk adjustment data for market level reporting used by market CEOs and staff
  • Support prospective risk adjustment program by supplying key data which helps drive the member and provider encounter
  • Assist with Ad-hoc projects

 

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: 

  • Bachelor’s Degree
  • 6+ years of risk adjustment experience and / or actuarial/consulting/finance/other analytical experience in the health care industry
  • Experience using models that involve large datasets
  • Proven technical expertise with Medicare risk adjustment methodologies
  • Intermediate or higher level of proficiency with SAS and SQL programming
  • Advanced or higher level of proficiency with Excel

 

Preferred Qualifications:

  • ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries) designation
  • Knowledge of ETL processes
  • Solid knowledge and understanding of data bases and related reporting technologies.
  • Demonstrated ability to effectively report data, analyze facts and exercise sound judgment when making recommendations to members of the Senior Leadership Team
  • Demonstrated ability to analyze problems, draw relevant conclusions, develop processes and communicate statuses and results

 

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

 

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 $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

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.  

Additional Job Detail Information

Requisition Number 2286579

Business Segment UnitedHealthcare

Employee Status Regular

Job Level Director

Travel No

Country: US

Overtime Status Exempt

Schedule Full-time

Shift Day Job

Telecommuter Position Yes

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