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Job Details

UnitedHealth Group

Business Process Analyst - Las Vegas, NV (105840162)

Business Development




Las Vegas, Nevada, United States

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Business Process Analyst, Associate will be responsible for quality improvement functions affecting members and providers, working with inpatient and outpatient providers and the clinical and case management team. This function includes management of member/provider complaints, HEDIS performance, compliance tracking and NCQA education to others. This role will perform daily data entry/tracking tasks and individual projects as assigned.

Location: Las Vegas, hybrid (3 days in office, 2 days remote)

Primary Responsibilities:

  • Leads process design and project implementation teams in process improvement activities
  • End-to-end business process activities - creating, controlling and improving business processes
  • Maintains NCQA standards for behavioral health including Utilization Management and Case Management
  • Diagnose process improvement opportunities and develop solutions using principles of process excellence and related tools
  • Quality reporting, analysis and audits and for developing plans and programs to support continuous quality improvement using applicable tools
  • Assist in the creation, implementation, and evaluation of Total Quality Management (TQM) programs
  • direct design, facilitation, training and evaluation of TQM incentive programs and may oversee quality improvement projects and teams
  • Assist in external auditing, licensing and contract reviews (EQRO)

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 or 2+ years of demonstrated quality assurance/quality improvement
  • 3+ years of experience in health care insurance systems and processes
  • Ability to commit to Hybrid work model - 3 days in office, 2 days from home
  • Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance

Preferred Qualifcations:

  • Working Knowledge of NCQA Accreditation Standards
  • Working Knowledge of HEDIS Measures
  • Knowledge of mental health terminology
  • Project management skills
  • Ability to communicate effectively with different groups/individuals.
  • Ability to handle confidential and sensitive information.

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

Nevada Residents Only: The hourly range for Nevada residents is $23.94 to $42.40. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.