Performance Analyst

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.

About the role

As a Performance Analyst, you will be a member of the Performance and Risk Adjustment team. You'll play a key role in managing data about the physicians and specialists who are part of our provider networks, conducting chart reviews, monitoring performance, and participating in improvement initiatives in conjunction with Provider Relations, health plans, and providers.

Location: 6760 Top Gun St. (Suite 201) San Diego, CA. This is a hybrid role, requiring onsite training for about 3-4 weeks upon hire and onsite attendance about 1-2 times monthly. Candidate must reside in Southern California and be willing and able to travel to the San Diego office.

Responsibilities

• Generates reports for department workflow, production, quality monitoring and performance improvement
• Participates in formulating improvement initiatives/solutions and assists with execution
• Reviews AWVs and other charts for HCC diagnoses and quality codes and processes them into tracking programs
• Recommends training opportunities and participates in provider training as needed
• Audits and interfaces with outside coding vendors
• Participates in webinars, conferences and conducts research as needed to stay abreast of IHA/NCQA/CMS requirements
• Serves as the user expert for software systems
• Audits software accuracy from time to time and participates in testing
• Attends user meetings and reports systems issues to the vendor
• Tracks and submits audit data for program compliance
• Performs other duties as assigned

Requirements

• Coding certifications from either AHIMA or AAPC
• 2+ years of experience in the healthcare industry
• 1+ years of experience working with CPT and ICD-10 codes and reading claims forms/reports
• Access to reliable transportation and the ability to come onsite to San Diego office, as needed

Preferred Qualifications

• Based in San Diego, CA
• Knowledge of HEDIS
• Knowledge of managed care concepts and healthcare delivery systems
• Understanding of health insurance industry and products
• Solid computer literacy, including competence with database and spreadsheet programs
• Microsoft Office products familiarity
• Demonstrated ability to work with changing priorities and varying deadlines
• Proven excellent organizational and interpersonal skills
• Proven organized self-starter with good follow-through

Schedule

4 10-hour shifts (Monday-Thursday, 6:30am-5pm PST)

Benefits

• Competitive base pay
• Paid Time Off (accrued from first pay period) plus 8 paid holidays
• Medical plan options along with participation in a Health Spending Account or Health Savings Account
• Dental, Vision, Life & AD&D Insurance along with Short-term and Long-Term Disability coverage
• 401(k) Savings Plan
• Employee Stock Purchase Plan
• Education reimbursement
• Employee discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• Performance rewards and recognition programs

Pay

The hourly pay for this role will range from $24 - $43 per hour based on full-time employment.