HEDIS Clinical Quality Analyst Sr - Remote

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.
UnitedHealthcare’s Quality Optimization and Insights (QOI) is an integrated team serving all UnitedHealthcare businesses, focused on delivering operational efficiencies for centralized activities. Our Operations and Engagement group is vital to our success and are leaders in driving the future growth of UnitedHealthcare. Success in this role relies on many factors - your ability to deal with ambiguity, your ability to adapt and embrace change, and a long-term commitment to making health care better for everyone.
QOI combines talented individuals from many areas of quality. Our goal is extraordinary performance that exceeds the expectations of the constituents, customers and members we serve. This role’s primary function is to perform and/or facilitate functions ensuring Prospective and HEDIS® quality reporting requirements are met in accordance with NCQA, CMS and State technical specifications. Position will support accurate and timely issue resolution and data reporting and provide overall Prospective support. The position will also monitor and track custom measure/deliverable development with our external vendor and internal partners. All work supports Commercial, Medicare & Medicaid quality improvement programs. This position reports to the Associate Director, QOI Processing Management & Configuration Team (PMCT).
The position is able to telecommute; however, work hours are either Eastern or Central time zones.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
• Perform and/or facilitate functions ensuring Prospective and HEDIS® quality reporting requirements are met in accordance with NCQA, CMS and State technical specifications
• Support accurate and timely issue resolution and data reporting and provide overall Prospective customer support
• Support the monitoring and tracking of custom measure / deliverable development with our external vendor and internal partners
• Collaborate with applicable internal stakeholders to obtain in-depth information / data about internal / external customer requirements for technology supporting Quality Optimization and Insights
• Support research to help establish current and emerging customer / market needs and trends (e.g., competitor technology analysis)
• Gather and document requirements from the client / business while focused on process improvement, workflow, benchmarking and/or evaluation of business processes and/or configuration
• Gather / analyze / validate applicable data from internal and external sources (e.g., clients, prospects, potential customers) to identify customer / market characteristics, needs, and problems (e.g., market opportunities, financials, technology trends, user preferences industry / regulatory / legal standards, internal product trends)
• Develop an understanding of the competitive quality metrics technology landscape (e.g., strengths, weaknesses, gaps, product portfolios, win / loss analysis)
• Document / communicate market characteristics and needs to applicable stakeholders (e.g., product management)
• Anticipates customer needs and proactively develops solutions to meet them
• Serves as a team support resource on complex and / or critical issues
• Reviews work performed by others to ensure data accuracy
• May support functional or segment teams or projects
• Provides explanations and information to others on complex issues
• Motivates and inspires other team members
• Works with minimal guidance; seeks guidance on only the most complex tasks
• Support the development of ad-hoc reports
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
• 3+ years of HEDIS® or CMS stars submission experience
• Experience working in the healthcare industry
• Intermediate or higher proficiency in MS Excel
• Demonstrated ability to manage and prioritize deliverables
Preferred Qualifications
• Systems Analyst or Business Analyst experience
• SQL or Access knowledge and proficiency
• Proven excellent communication, time/project management, problem solving, organizational, and analytical skills
• Proven to be a team player and able to work with others as needed
• Demonstrated ability to work without a lot of direction
• Demonstrated ability to manage multiple projects at any given time
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment

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