National Medicaid Quality Analyst – Remote

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

The Clinical Quality Consultant is responsible for providing direction and guidance on clinical quality improvement and management programs to enable markets to achieve distinctive levels of performance in the quality space, and most especially in support of RFP’s and growth. Prepares quality scorecards and competitive, opportunity assessments for all Medicaid markets. This position is responsible for the reporting and actionable insights of member care quality and for developing plans and programs to support continuous quality improvement and integration of entities and plans within the UnitedHealthcare enterprise.

Positions in this function are responsible for direction and guidance on clinical quality improvement and management programs including NCQA Health Plan, Equity Accreditation and Health Equity Plus Accreditation. 

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

Primary Responsibilities:

• Works closely with regional quality staff, health plan staff, and internal business partners to build and document competitive position for HEDIS, P4P, auto-assignment, PIP’s accreditation and other market specific metrics- especially in advance of RFP’s
• Access HEDIS and other data sources to pull together information for RFP and growth insights and proof points
• Manipulate complex data and draw conclusions
• Complete reports that provide analysis of data related to key quality projects to include member and provider engagement programs
• May present results of information to diverse stakeholders
• Organizes and/or participates in readiness assessments in preparation for RFP’s in partnership with the growth teams
• Interface with National Medicaid analytic and reporting teams to QA resources and ensure they are presented in optimal user-friendly formats
• Participates in the development and distribution of accreditation best practices
• Serves as a technical advisor for national Medicaid Quality team resources
• Develop policies and procedures that support activities
• Supports implementation of quality at state, regional and national levels

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:

• 3+ years of experience with HEDIS reporting, healthcare data analytics, or quality measurement
• Experience with data visualization tools (e.g., Tableau, Power BI)
• Familiarity with NCQA HEDIS technical specifications and clinical data abstraction workflows
• Advanced SQL, VBA, and Excel skills and experience working with large datasets in relational databases

Preferred Qualifications:

• Experience with process automation tools
• Knowledge of claims data, EHR/EMR systems, and data integration techniques
• Familiar with Medicaid regulatory requirements
• Understanding of health plan operations and quality improvement programs (e.g., P4P, HPR, STARS, CAHPS)

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.