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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Medical and Clinical Operations



Approximate Salary:

Not Specified

Position Type:

Full Time

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Clinical Quality Measures Business Analyst - Minneapolis or Telecommute

UHG - Eden Prairie, Minnesota

Posted: 12/7/2018

For you, quality counts. For UnitedHealthcare, part of the UnitedHealth Group family of businesses, delivering quality care starts with processes and documentation standards that are the best in our industry. As a Senior Clinical Quality Analyst, you'll be a force for positive change, guiding the development of comprehensive care plans that will help others live healthier lives. Join us and help guide our efforts to improve the patient experience.


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



  • Transform quality measures such as HEDIS, PQA, P4P, ACO and custom client measure specifications into text instructions in Excel so the developers can program requirements for the engine

  • Test case development for measures (i.e. test measure logic)

  • Documentation. BA team provides both internal and client documentation

  • Provides 2nd tier customer support

  • Coordination with developers, product management, and QA team

  • Certification for HEDIS and P4P (e.g. receipt of test decks from NCQA, coordination of testing, and revising measure logic as needed) 

Required Qualifications:

  • Experience with aspects of national quality measures (through provider groups, payers, state/federal institutions), such as HEDIS, Medicare Stars, PQRS, Meaningful Use, State Medicaid programs.  This experience could include quality improvement initiatives, reporting, EHR/Practice Management data analysis, writing business requirements or technical specifications, etc.
  • Working knowledge of administrative claims data and medical coding systems (i.e. CPT, HCPCS, ICD-10, NDC) 
  • Experience with project and/or product management and lifecycles
  • Solid PC computer skills with proficiency in MS Office applications
  • Understanding of data inputs, outputs, relational database concepts

Preferred Qualifications:

  • Bachelor’s Degree
  • ICD-10, CPT and HCPCS coding experience
  • Understanding of clinical taxonomies (SNOMED, LOINC, RxNORM, etc)
  • Knowledge of relational database structures
  • Experience writing queries in analytics tools such as SQL or Microsoft Access
  • Strong attention to detail and accuracy
  • Excellent written/oral communication and listening skills
  • Excellent evaluative, analytical and problem-solving skills
  • Ability to understand complex requirements and derive solutions

If you're the kind of thinker and leader who wants to bring your contribution to a new level every day, here's your opportunity to do your life's best work.(sm)


*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: HEDIS, PQA, P4P, ACO, STARS, test release, Business Analyst, BA, telecommute, HCPCS, ICD-10, NDC, NCQA, CPT, Access, SQL, LONC, SNOMED, RxNorm, Telecommute, Telecommuting, Telecommuter, Work from home, WFH, Remote

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