Data Analyst II - Risk Adjustment Analyst - San Antonio, TX

    • San Antonio, TX

Position Description

The Risk Adjustment Analyst supports the Sr. Vice President of Risk Adjustment by providing professional assistance, project management, and recommendations on business needs. The position is responsible for providing analysis skills, monitoring organizational performance to plan, identifying factors to determine and recommend areas of business development and enhancement, and developing clear action plans to drive processes.

Primary Responsibilities:

  • Examines and performs statistical and data management analyses, develops and presents a variety of performance results in addition to other pertinent communication. Transfers data into meaningful, professional, and easy to understand formats for leadership. Reviews data, develops recommendations and reviews findings with senior management
  • Analyzes and extracts data from the Enterprise Data Warehouse (EDW) and other sources to report to internal and external customers
  • Designs, develops, tests, documents and maintains database queries for ad hoc reporting used in complex conceptual analyses for all departments within Risk Adjustment Operations and for external departments such as Finance (HCE) or other Care Delivery Organizations (CDOs) within the Optum family
  • Develops systematic reporting processes and procedures to ensure timely delivery of daily, weekly, monthly, annual, and ad hoc reports to support key departmental and corporate initiatives
  • Recommends and implements new or modified reporting methods and procedures to improve business processes, report content and completeness of information
  • Serves as the liaison between departments, markets and IT for all Risk Adjustment reporting needs. Troubleshoots all errors and data inconsistencies and coordinates resolutions to issues as directed by self, staff, regional market leadership, and corporate management
  • Acts as a single point of contact for assigned Risk Adjustment programs and projects, as warranted. Plans, develops, implements and evaluates programs and projects, coordinates business goals and objectives, collaborates with project team members, develops measureable project goals and objectives and monitors progress to completion. Facilitates communication between team members and identifies and coordinates assignment of internal and external resources to meet project requirements
  • Plans and assists with testing processes and activities including new report or analytics methodology validation
  • Conducts project meetings to include meeting regularly with project team to review deliverables and deadlines. Responsible for developing and updating various types of project documentation such as communication plans, project schedules, issue logs, etc.
  • Responsible for documenting and updating changes to workflow, training plans, policies and procedures, as directed
  • Performs complex business analysis using appropriate project tools and identifies best practice approaches to ensure overall project success
  • Performs all other related duties as assigned

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 Economics, Finance, Statistics, Mathematics, Actuarial Sciences, or other quantitative discipline required. 4 additional years of related experience beyond the minimum required may be substituted in lieu of a degree
  • Four or more years related experience in operations reporting and analytic capacity required
  • Proficient in SQL, MS Excel, Tableau and/or equivalent data capture/reporting tools required
  • Excellent analytical and problem-solving capabilities with special attention to accuracy and detail required
  • Proven ability to successfully conceptualize an initiative, develop a plan and execute the plan through implementation required
  • Experience in maintaining motivation to accomplish goals under stringent timelines required
  • Ability to interact one on one and consult with all levels of executive management required.


Preferred Qualifications:

  • Two or more years of Healthcare or quality/risk adjustment experience
  • Experience in creating dashboards and reporting visualizations
  • Coding experience to include Python and/or R
  • Experience utilizing databases and data management
  • Ability to work with minimal guidance.


Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 380,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Data Analytics, Sr. Data Analyst, Risk Adjustment Analyst, WellMed, Optum, UnitedHealthcare, UHG, EDW, SQL, Tableau, San Antonio, TX, Texas


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