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Job Details

UnitedHealth Group

Senior Business Systems Analyst - HEDIS - Telecommute (105970435)

Business Development




Eden Prairie, Minnesota, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The Sr. Business Analyst, Structured Data Management & Audit Support is responsible for participating in and overseeing a team dedicated to the evaluation and management of supplemental data sources (SDS) including source verification & documentation for audit, data collection and validation, data provisioning oversight and HEDIS® audit support, as well as consultative service related to supplemental data for the Enterprise Clinical Data & Interoperability (ECDI) organization. The team member will collaborate with the Single Data Repository (SDR) team, PEDS, Quality & Value Solutions Delivery (QVSD) and other appropriate areas of the business, to ensure the most efficient management of data for the greatest Enterprise gain. All work of this team supports Commercial, Medicare & Medicaid quality improvement programs.

Additionally, this role will support process improvement through the identification, verification and documentation of data source management processes, as well as development of associated action plans. The team member, Source Data Management & Audit Support will report to the Associate Director and will be responsible for all reporting of HEDIS® audit documentation, ensuring a successful HEDIS® audit outcome.

The position is able to telecommute however work hours are either Central or Eastern Time zones.

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

Primary Responsibilities:

  • Subject Matter Expert - HEDIS® Audit
    • Stay current with current NCQA HEDIS® Technical Specifications with each annual update
    • Remain familiar with current Medicaid quality requirements as they relate to supplemental data managed by ECDI
    • Consultative resource for measures and reporting requirements for HEDIS® (per technical specifications) across the enterprise (all lines of business, clinical & operational business units)
    • Consultative resource for external data sources who provide supplemental data to the enterprise
    • Support education & training to ECDI organization as it related to supplemental data use throughout the enterprise
    • Prepare presentations for Study Hall level meetings
  • Source Management
    • Manage master list for supplemental data sources, including submitter-level information, for all internal and external sources where supplemental data is used throughout the enterprise
    • Track work plan associated with maintaining and obtaining supplemental data, managing auditor requirements and associated documentation
    • Manage and track data validation effort as needed for audit documentation for all supplemental data sources and submitters
    • Manage audit documentation completion and delivery to Quality & Value Solutions Delivery
    • Track supplemental data sources, this includes collaborating with other resources sharing responsibilities for specific SDS relationships
    • Participate in activities/technologies which impact supplemental data including HIEs, Local Care Delivery and initiatives to increase receipt of EMR data
    • Work with internal ECDI partners to better define supplemental data source requirements for development and implementation of new sources
    • Lead team collaboration to develop action plans to implement those sources into existing production
    • Maintain and communicate metrics pertaining to supplemental data source management
  • Audit Management
    • Support Quality Solutions Delivery with HEDIS® audit - for all audit groups involved with annual audit
    • Maintain documentation required to support use of supplemental data for HEDIS® for auditors and internal requirements
    • Maintain and communicate metrics pertaining to HEDIS® audit support activities
    • Complete work on time, especially as it pertains to HEDIS® audit deadlines
  • Support the Audit Support team through HEDIS® season activities (see Source Management, Data Management, Audit Management)
  • Identify & lead efforts for continuous process improvement, including staff development and engagement
  • Serve as a leader/ mentor and sought out as expert
  • Execute on communication plan pertaining to supplemental data source management
  • Assesses and interprets customer needs and requirements
  • Gather & document requirements for project initiation
  • Develop & produce ad-hoc reports
  • Solves complex problems and/or conducts complex analyses
  • Works independently; seeks guidance on only the most complex tasks
  • Works collaboratively with Quality Solutions Delivery, SDR and PEDS teams
  • Support national projects /pilots

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 experience in lieu of a degree
  • 6+ years of combined experience in a Business Analyst/IT role
  • 3+ years of experience in Healthcare Industry with Quality/Process Improvement focus with understanding of medical terminology and clinical care
  • 2+ years of demonstrated success with project management
  • 2+ years of experience with HEDIS® documentation and auditing processes, preferably with auditor-facing experience

Preferred Qualifcations:

  • Experience writing SQL queries
  • IT experience with data collection, processing, analysis and reporting
  • Understanding of data gathering/analysis
  • Advanced MS Excel and MS Access skills
  • Advanced proficiency with MS Office (Including Word, Outlook, PowerPoint, Visio)
  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

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

Technology Careers with Optum. Information and technology have amazing power to transform the health care industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life's best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. 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.

*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.