Risk Adjustment, Associate Director Healthcare Economics - Remote

Requisition Number: 2340242
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 the Optum Health National Risk Adjustment Healthcare Economics Team, we support all risk adjustment efforts across our enterprise, primarily focused on Medicare Advantage Risk Modeling and Financial Forecasting. Our current major initiatives focus on standardizing and centralizing forecasting processes for Medicare Advantage Risk Adjustment across all markets with a focus on enhancing data quality, accelerating forecast production, and improving alignment with Finance and Accounting partners.
We are internal analytics partners who provide expertise to our finance, operations, accounting, and clinical leads to forecast, reconcile, and analyze revenue and risk. If you eat, breathe, and sleep forecasting like we do-or if you're driven, collaborative, and eager to learn-this is the place for you.
As an Associate Healthcare Economics Director, you will be responsible for guiding the development and rollout of standardized forecasts, overseeing data transitions, mentoring analysts, and serving as a trusted partner to both market and national stakeholders. You will also work closely with data engineering teams to shape intake processes and ensure forecast-ready data pipelines.
The role requires expert knowledge of CMS Medicare Advantage payment models, strong SQL and Excel skills, and experience working with large, complex healthcare datasets-preferably in Snowflake or similar modern platforms.
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you lead critical components of this enterprise initiative.
Primary Responsibilities:

• Serve as forecasting lead for multiple regions or sub-CDOs, owning model development and revenue delivery
• Oversee forecast intake, development, and review processes, ensuring accuracy and consistency across markets
• Collaborate with data engineering, finance, and operations partners to align data sources, forecast methodologies, and delivery timelines
• Contribute to the design and implementation of centralized forecast infrastructure within platforms like Snowflake
• Guide junior team members and analysts by providing mentorship, review, and technical direction
• Translate complex analyses into actionable insights for executives and cross-functional teams
• Ensure alignment with CMS risk adjustment methodologies, regulatory guidance, and industry best practices
• Present forecasts, insights, and recommendations to senior leadership and national stakeholders

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 in Mathematics, Statistics, Economics, Finance, or a related field
• 5+ years of healthcare analytics or forecasting experience, with 2+ years in a lead or strategic role
• Demonstrated experience using CMS Medicare Advantage data files, including MMR, MOR, and MAO-004, in support of forecasting, reconciliation, or program performance analysis
• Advanced to expert proficiency in SQL, with demonstrated experience managing large datasets
• Advanced Microsoft Excel skills (e.g., complex formulas, modeling, automation)
• Solid understanding of CMS Medicare Advantage Risk Adjustment models and their application to revenue forecasting
• Proven ability to lead complex analytic projects and coordinate across functional teams

Preferred Qualifications:

• Master's degree in Mathematics, Statistics, Economics, Finance, or a related field
• Experience building and deploying forecasting models in a healthcare payer or provider setting
• Expertise in interpreting MMR and MOR reports, identifying discrepancies in MAO-004 submissions, and integrating these into financial or operational reporting
• Experience building logic for forecast reconciliation using CMS payment and encounter data files
• Familiarity with data infrastructure and ingestion pipelines, especially in Snowflake
• Experience leading teams or mentoring junior analysts
• Skilled in presenting technical concepts to executive audiences
• Solid project management and documentation skills

*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 $112,700 to $193,200 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.
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.