You are a thought leader who thrives on developing new solutions to solve tough challenges. As a critical member of our business analysis team, you will help rewrite the future of UnitedHealth Group. Here, your analytical and innovative skills will help us with our mission of helping people live healthier lives. Yes, we share a mission that inspires. And we need your organizational talents and business discipline to help fuel that mission. Are you ready to analyze data and deliver bold, business-savvy ideas to impact the lives of millions?
As a Program Manager, Clinical and Quality Solutions, you will be empowered to support short and long term operational / strategic business activities; develop, enhance and maintain operational information and models that will have an impact on business decisions. In this leadership role, you will have the opportunity to take the contributions of analysts and create valuable solutions to improve the health care system. Join us! Your passion for performance can fuel your life’s best work.(sm)
Primary Responsibilities:
- Manage client priorities and coordinate internally with various stakeholders to successfully manage HEDIS / Stars projects on behalf of clients
- Understand payer challenges and basic concepts of CMS Quality Programs
- Demonstrates ability to consistently follow published HEDIS and Stars technical specifications and manage annual and ongoing HEDIS projects
- Analyze, review, forecast, and trend complex data
- Function as the first point of contact for all client questions (e.g. provide primary software support for clients)
- Provide software training to clients
- Thorough understanding of measure analytics to perform investigative research
- Manage customer expectations, and provide critical feedback to software development personnel
- Directs/provides enhancements to business processes, policies and infrastructure to improve operational efficiency across the organization
- Take a leading role in assisting the QI leadership in the evaluation of patterns and trends related to HEDIS, CAHPS, HOS data
- Provide strategic support in the development of member / provider incentive programs
- Be able to manage and prioritize large projects with great visibility
Qualifications
Required Qualifications:
- Bachelor’s Degree or equivalent experience
- 3+ years of experience with data analysis in a health care delivery organization, such as a managed care organization
- 3+ years of CMS Stars and / or HEDIS experience, performing a wide range of functions with strong focus on data analysis
- 3+ years of process improvement and / or project management experience
- 3+ years of experience gathering and documenting requirements from clients
- Intermediate level of proficiency with MS Excel and PowerPoint
Preferred Qualifications:
- Experience working in a matrix environment
- Experience with claims and claims processing
- Knowledge of Medicaid and / or Medicare programs
- Knowledgeable of current trends in HEDIS in managed health care
- Knowledgeable of NCQA, CMS, HEDIS, HOS and CAHPS requirements
- Ability to work with and be comfortable with ambiguity
- Ability to manage and prioritize large, highly-visible projects
- Ability to communicate analysis including trends and opportunities to clients in writing and verbally
- Intermediate level of proficiency with MS Access
Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.(sm)
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: HEDIS, CMS Stars, data analysis, project management, remote, work from home, telecommute, telecommuter, telecommuting
EmoticonEmoticon