Quality SER Analyst, Kelsey-Seybold Clinic

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. 

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

Primary Responsibilities:

• Review, test, and validate Epic Tapestry and Epic Benefit Engine build including but not limited to PVP build (provider, vendor, and place of service), provider contracts, EDI and Eligibility load processes, fee schedule maintenance, implementation and upgrades to software applications, and benefits testing
• Coordinate all testing initiatives, develop test plans and test cases/scripts and identify/implement enhancements to existing test scripts, create/maintain policy and procedure document library for the
• Tapestry System Support Team, and perform retro-adjudication on a recurring and ad hoc basis
• Provides exceptional customer service to all departments, achieve an in-depth knowledge of Epic software, and develop a close working relationship with business owners and stake holders
• Other duties as assigned

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:

• 4 year degree (BA, BS in business or other related field) or comparable Information Systems Application experience or KSC experience (will substitute experience year-for –year to meet education requirements)
• 2+ years of experience with healthcare applications, system design, configuration, or support
• Demonstrated knowledge of claims processing, vendor contracting, and benefit plan building
• Epic Tapestry Proficiency required within 9 months of assuming position
• Epic Benefits Proficiency required within 18 months of assuming position
• Proven solid ability to translate administrative and operating requirements specific to Epic Tapestry System into clear, specific actionable system configurations and understand how to implement those configurations
• Proven ability to test and audit Tapestry system configurations to assure functional accuracy
• Microsoft office including Excel,Teams, Visio
• Proven excellent written and verbal skills. Ability to read and interpret industry documents
• Proven flexible, detail oriented, and able to work within tight deadlines
• Proven to exhibit exceptional customer service to internal and external customers
• Valid Driver’s License

Preferred Qualifications:

• 4+ years of experience in a Managed Care environment, preferably using Epic Tapestry
• Experience in a Quality Assurance Role
• Demonstrable knowledge of clinical data sets (CPT, HCPS, ICD-9)
• Proven solid analytical and reporting skills

Essential Duties:  

• Review, test, and validate Epic Tapestry build
• Coordinate all testing initiatives
• Develop test plans and test cases/scripts and identify/implement enhancements to existing test scripts
• Create/maintain policy and procedure documents for the Tapestry System Support Team
• Perform retro-adjudication on a recurring and ad hoc basis.
• Other duties as assigned

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

OptumCare 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.

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