Medicare Stars Analytics Consultant Telecommute

The Medicare Stars Analytics Consultant will support the STARS audit process for Optum Complex Care Management members. This audit process will focus on all CCM Clinical Programs (HouseCalls, ISNP, IE-SNP, DSNP Optum at Home and Post-Acute Care). All aspects of STARS data flow will be in scope from documentation in EMR to Supplemental Data to data submission to prospective / retrospective HEDIS engines.

The Medicare Stars Analytics Consultant position will audit (research, analyze and report) various aspects of the HEDIS data flow to ensure the highest level of data quality. The position will work with internal and external businesses, as well as technology constituents to understand and validate data and processes. The position will create and lead projects, as appropriate, to enhance the performance and monitoring of data submission for clinical quality measures.

This role will also support HEDIS roadmap documentation for internal and external clients.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Research and analyze the data and processes associated with quality measure data from existing EMR platform which feed the supplemental data process.
• Understand HEDIS and NCQA technical specifications and apply measure criteria
• Collaborate with internal analytics teams to understand clinical quality data flows: create alignment on data analytics methodologies used, identify and resolve data issues as they arise, and coordinate projects to implement changes
• Serve as a key resource to conduct internal data audits, develop analysis and documentation to support findings; present summary to technical teams and leadership
• Collaborate with internal cross functional teams to assist in the development and review of business and technical requirements
• Lead and drive work streams to enhance short and long-term clinical quality reporting activities
• Confident customer-facing approach: can defend analysis, can take input / feedback, and can consultatively say no by providing a range of alternatives, particularly those promoting a standard approach

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 Business, Health Administration, related field or equivalent work experience. Master’s degree a plus
• 5+ years of experience in healthcare industry
• 3+ years of experience with data analysis using tools such as: SQL, Tableau, MS Access
• Advanced skills with MS Excel: v-lookups, pivot tables, formulas
• Ability to interpret HEDIS/clinical quality measure specifications and experience with HEDIS medical record retrieval and data submission
• Proficient with MS software programs (Visio, PowerPoint, etc.)
• 3+ years of experience with process improvement, workflow, benchmarking and / or evaluation of business processes
• Ability to work in a fast paced, complex organization
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:

• Previous HEDIS /Medicare Star Ratings experience
• Experience with medical and/or pharmacy claims data

Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Colorado Residents Only: The salary/hourly range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

Job Keywords: SQL, Business Analyst, Data Analyst, Healthcare Economics, HEDIS , Telecommute