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.
Positions in this function are responsible for the reporting and analysis of member care quality and for the development of plans and programs to support continuous quality improvement, including interpreting reporting and/or measure requirements to meet internal and external customer needs. Reports to the Quality Director.
If you are located in Richmond, VA, you will have the flexibility to telecommute* as you take on some tough challenges. Must be able to travel to Richmond for meetings with customer
- Design, create and implement quality improvement projects and initiatives
- Conduct and manage outcomes of various studies that may include analyzing, reviewing, forecasting, trending and presenting information for quality management planning and management needs
- Read and interpret standards/requirements and technical specifications (e.g., structure and process, CMS star ratings, NCQA/HEDIS/CAHPS) in order to develop and/or run data queries
- Use problem solving skills to systematically analyze problems, draw relevant conclusions, and devise appropriate courses of action
- Develop and implement effective analysis, research and evaluation of quality management metrics
- BS / BA degree
- 2+ years of experience in reporting and/or data management
- 2+ years of experience in interpreting technical specifications and analyzing data
- Advanced level of Microsoft Excel (proficiency with reporting, sorting, filtering and formulas)
- Experience leading functional or segment teams or projects
- Must be able to travel to Richmond for meetings with customer
- Experience working for a Medicaid and/or Medicare health care regulator or insurance organization
- Experience with quality measures such as HEDIS
- Experience with SQL
- Experience developing and implementing performance improvement projects or using data to develop intervention strategies to improve outcomes
- Experience utilizing problem solving and data analytical skills
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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: Clinical Analyst, Senior Clinical Quality Analyst, Clinical Analyst, Analyzing, Analyze, audit, Excel, reporting, sorting, filtering, formula, Excel, Access, data, data analyst, manipulation software, quality, NCQA,HEDIS.CAHPS, SQL, quality improvement projects, PM, Project Manager, trends, data trends, data queries, analysis, research, evaluation, quality management, quality improvement, Richmond, VA, Virginia