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Quality Senior Program Analyst
Irvine, California
Caring. Connecting. Growing together.
With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve.
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
The Quality Senior Program Analyst will provide operational support, monitoring and direction to the Quality Performance Coordinators (QPCs), responsible for coordinating and implementing quality programs, projects, and tasks, ensuring timely completion of goals. This role will collaborate with internal and external key stakeholders, regional operations, IPA practices, FQHCs, and other community partners, to drive clinical relationships and engagements between members and their care delivery system. This focus of this role is Medi-Cal quality metric performance, which may include but is not limited to HEDIS and CMS Measure gap closure, and CAHPS/HOS patient experience performance.
The ideal candidate will be:
- Self-directed, able to manage multiple priorities, and coordinate complex cross-functional project plans, in order to drive execution of PI strategies
- Accountable for improvement on HEDIS and STARs gap closure, improved patient experience and optimized patient outcomes
- Skilled at utilizing data to drive decisions, and has a passion for applying technology to achieve systematic solutions
- Passionate about continuous improvement, streamlined processes and workflow optimization
- Energized by new challenges, thrives in a fast-paced, dynamic environment, collaborates well in a team-oriented atmosphere
This position follows a hybrid schedule with three in-office days per week.
Primary Responsibilities:
Under the supervision of the VP, Government Programs and in collaboration with other stakeholders, the Quality Senior Program Analyst will help create and implement programs that improve the health, well-being, and quality of care and service received by our Medi-Cal members, as demonstrated by high quality measure performance. The goals of the program may include:
- Drives quality performance (e.g., HEDIS, CMS, CAHPS) by executing strategies on assigned measures and monitors performance
- Leads engagement strategy for QPC targeted provider practices; collaborates with regional stakeholder teams/teammates on improvement workplans
- Leads NEW QPC onboarding, training and education
- Supports QPCs to ensure work plans are successfully executed in a timely manner
- Provides quality programmatic support to FQHCs and other strategic community programs and projects
- Supports programs integrating in-office embedded and wrap-around support including but not limited to patient scheduling, chart reviews, targeted mailings and IVR campaigns, workflow optimization and visible performance tracking
- Provides new office staff/ new and refresher quality overview trainings
- Facilitates Cozeva trainings and of best practice workflow implementation; promotes and supports EHR-Cozeva integration opportunities
- Collaborates and aligns strategies with other regional support teams (e.g., Provider Relations and Population Health)
- Maintains performance tracking related to own and QPC team assigned projects, ensuring timely and accurate execution and documentation; uses performance reports to track and trend progress
- Participates in required meetings related to Medi-Cal Pay for Value (P4V) performance, measure updates, etc.
- Stays informed on all member outreach activities and communication schedules, and shares updates to assigned practices
- Supports continuous performance improvement through research and testing of new initiatives to assess success and scalability
- Provides continuous feedback to manager and team on performance, barriers, opportunities, and action plans for all assigned practices
- 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:
- 5+ years of supporting programs in HEDIS Quality, Stars, CAHPS/HOS experience
- Experience with managed healthcare / care delivery business operations
- Experience working directly with clinicians, provider practices and/or care delivery networks
- Proven intermediate MS Office skills
- Proven PowerPoint Presentation skills
- Proven excellent communication skills
- Valid CA Driver's license, current insurance and reliable transportation to local provider offices
Preferred Qualifications:
- Provider office administrative or call center experience
- Experience with Technology-based Solutions (EHRs, IVR, Texting Applications, etc.)
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 $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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
Benefits
Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.
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