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Job Category:

Information Technology



Approximate Salary:

Not Specified

Position Type:

Full Time

Provider Implementation Project Manager - Minnetonka, MN or Central Time Zone Telecommute

UHG - Dallas, Texas

Posted: 11/15/2018

The trend is clear: CMS Star ratings are improving, the market is becoming increasingly competitive, and members will continue to prefer Four Star and higher-rated plans (weighted by enrollment, 4+ Star plans serve almost 60 percent of enrollees). The financial return of achieving Star ratings of 4+ is substantial, enhances our brand in the market, and is commensurate with who we are as a company.


The UHG Stars reporting efforts are complex.  The program is supported by diverse technologies and processes, delivered in some cases in siloes.  Many of the processes are manual, and the teams that own individual processes work in different parts of the UHG organizations.  Overall efficacy of Stars gap closure and reporting is hampered by the diversity of the supporting technologies and the complexity and diversity of the manual processes.


The ‘Stars Tech Team’ (project team) believes that it is possible to rationalize the technologies and processes that support Stars.  The rationalization would both decrease the costs associated with Stars compliance and improve Stars scores as well.


The Clinical & Admin Data Services Management Team is focused on building clinical data exchanges with providers in order to improve data accuracy and quality of care as part of UHC’s collective clinical programs.  This program is also involved in delivery of an integrated prospective and retrospective HEDIS processing, and simplification of provider onboarding and data submission.


The Provider Implementation Project Manager is responsible for the coordination and completion of major Clinical Data Services initiatives. The Project Manager will provide reasonable level of subject matter expertise in respective area of work including project management, project scope definition, risk identification, project methodology, resource allocation and meeting facilitation. The successful candidate is expected to complete his / her project on time and within scope and budget, provide project reports and manage indirect reports.


If you are located in central time zone, you will have the flexibility to telecommute* as you take on some tough challenges. Preference given to candidates in Minnetonka, MN


Primary Responsibilities:

  • Collaborate with all applicable areas (Regional Leads, PPMs and Field Staff, C&S, M&R, E&I, Stars)

  • Assure procurement of required documentation from provider groups required for audit (section 5), include EHR profiles, existing provider group attestations, PSV. This includes developing processes, educating staff, testing approaches, and troubleshooting as needed

  • Document processes, materials, decisions, outcomes, and communicate across teams

  • Lead and contribute to the development of program or project scope document, RACI, program/project charter, Statement of Work, Business Case / Vision Document

  • Manage project plans, dashboards and open issues/action items, change requests, budget and SOWs

  • Monitor and document project milestones and outcomes throughout the project lifecycle to ensure adherence to established quality standards

  • Develop, communicate and implement program and project risk, issue management plans and strategies

  • Develop and implement contingency and recovery plans when deliverables are missed (e.g., identify critical path, document, plan for getting back to Green, Business Continuity Plan, failover plan)

  • Manage various meetings (including kickoff meetings, requirements gathering meetings, weekly program status meetings, and issue resolutions)

  • Work closely with the supervisor to support managing the team from a project management perspective

  • Coordinate and facilitates project meetings, prepare status reports, liaison with other cross-functional groups

  • Work with the Business and IT on reviewing business case/vision documents, business requirements documents, and detailed design documents, as necessary

  • Ensure necessary quality assurance processes are in implemented and followed. Also support UAT (User Acceptance) testing for implemented solutions

  • Coordinate with Operation teams and validate successful file implementation and track file processing related performance

  • Partner with Technical team in optimizing and automating Provider onboarding, File ingestion, parsing, End2End Provider life cycle management, Dashboard and Reporting processes

Required Qualifications:

  • 10+ years of project management experience

  • 5+ years of experience in automation, optimization of file / data processing and data integration

  • 5+ years of experience facilitating and leading data solution design, architecture & delivery planning activities across geographically diverse and multi-disciplinary teams

  • Experience with complete software development life cycle including using Agile delivery methods

  • Demonstrated ability to gather detailed requirements from analyst, developers and end-users and writing business requirements for clinical data applications and data interfaces

  • General understanding of CMS Stars ratings, HEDIS and standard health care file formats included CCD, CCDA, XML, V3, C32, HL7, ORU, etc.

  • Medicare and / or Healthcare industry experience
  • PMP certification


 Preferred Qualifications:

  • 15+ years of project management experience

  • Proficient with MS Office Suite (Word, Excel, PowerPoint)

  • Proficient at using SharePoint

  • Knowledge of FHIR, REST and web services APIs

  • Knowledge of SQL and clinical data analysis

  • Demonstrated ability to work under pressure and manage multiple tasks simultaneously

  • Demonstrated communication skills including explaining complex concepts, negotiation and persuasion, conflict resolution, and presenting to executive levels management

  • Demonstrated ability to drive projects and be self-directed and motivated
  • Demonstrated ability to identify and resolve issues and roadblocks inhibiting completion of milestones
  • Experience in healthcare vertical including EMR, HIE or other provider or clinical data integration systems
  • Experience with integration technologies such as, Ensemble, Cache, HealthShare or other interoperability platforms such as Mirth, Orion Rhapsody, InterSystems or Optum
  • Experience with both common and emerging interoperability standards such as HL7 V2.x
  • SAFe or Agile certifications



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*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: project manager, PMP, clinical, interoperability, data, HL7, CCD, CCDA, STARS, HEDIS, health care, UnitedHealth Group, UHG, UnitedHealthcare, UHC, Minnetonka, MN, Minnesota

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