Risk Adjustment Coding Business Consultant - Remote - Remote Eligible

Risk Adjustment Coding Business Consultant

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

As a Risk Adjustment Coding Business Consultant, you'll provide coding consulting services to strengthen and improve health care operations that result in stronger financial returns and improved population health management. You'll use your subject matter expertise in risk adjustment and health care quality for meaningful performance improvement. In partnership with additional consulting staff, you will work closely with clients to ensure their needs are captured, opportunities for improvement are identified and critical deliverables are executed.

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

Primary Responsibilities:

• Serve as a coding subject matter expert for the business processes related to risk adjustment coding and audit operations
• Provide support and guidance on risk adjustment coding and clinical quality operations, accreditation, quality improvement initiatives
• Support root cause analysis and develop targeted interventions designed to improve clinical quality and risk adjustment outcomes
• Provide project management support for consulting engagements
• Provide consulting support for client engagements
• Assist in the development of written proposals and power point decks to support business development efforts
• Support business development/sales efforts by serving as a risk adjustment SME as part of client sales presentations and/or developing slide decks and written content to support RFP responses and client proposals

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:

• Must have a current, active Certified Risk Adjustment Coder (CRC) Certification
• 3+ years of experience working as a Certified Risk Adjustment coder
• 3+ years of health plan experience
• Experience working multiple concurrent projects
• Experience working with external client requirements and meeting with clients on coding findings and operations
• Experience presenting findings and recommendations to internal stakeholders
• Ability to travel approximately 25% as business needs dictate

Preferred Qualifications:

• Risk adjustment experience across product lines in addition to Medicare Advantage (i.e., Medicaid, ACA)
• Consulting experience
• End to end Risk Adjustment operations experience
• Proven Quality expertise (HEDIS®, NCQA Accreditation, Star Ratings)

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 $71,200 to $127,200 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.