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 and help people live healthier lives while doing your life's best work.(sm) The Managed Long Term Services and Supports (MLTSS) Clinical Analyst works closely with UHC leadership and other departments to ensure the integrity of clinical data and to execute the development and implementation of program operational reporting and performance measures. Define and analyze business and data requirements needed to accurately measure program effectiveness in the marketplace. As a Clinical Analyst you will be responsible for providing dashboards, reports (Production and Adhoc), consultation and analysis. Responsible for the development and implementation of data collection methodology to meet or exceed minimum performance standards established by the regulator, reporting and analysis of clinical performance measures and performance improvement projects. This is an office position at 9020 Stony Point Parkway, Suite 400, Richmond, Virginia. Potential for a telecommuter position in the future. Primary Responsibilities: Analyzes processes and makes recommendations for improvement Monitors plan reporting to ensure compliance with contractual requirements and performance targets Interfaces with third party subcontractors and internal quality teams to measure performance, document improvements and opportunities and develop remediation plans with plan leadership Business requirement development and documentation Health plan clinical department support, including care coordination and LTSS program operations Provides support for health plan projects and programs, including implementations, new programs and innovative solutions to address customer needs May lead small and mid-scale projects and initiatives for health plan Provides operational and analytical support for larger scale projects and programs Maintains sources of truth for health plan operations, vendor and other reporting Supports Joint Operating Committees and Business Partner Reviews Coordinates health plan's value added benefit fulfillment Develops processes and structures to ensure health plan fulfills on customer requests and requirements Supports both internal and external audits, including regulatory audits Identify and troubleshoot data anomalies and irregularities in process / procedure Develop and establish strong and effective working relationships with Clinical Program leadership and other departments Responsible for collecting and documenting business requirements for reporting and analysis initiatives
Required Qualifications: Bachelor's Degree in Computer Science, Mathematics, Statistics or related fields 2+ years of experience performing analysis, doing reporting and / or operational support Programming knowledge (reporting code) and of relational databases, database structures and design, systems design, data management, data warehouse This includes SQL and Crystal ReportsMicrosoft Access - write SQL, queries and macros Intermediate - Advanced proficiency with Microsoft Excel capabilities including experience with data manipulationPreferred Qualifications: Prior Customer Service experience within a Healthcare, Customer Service or Financial services organization Prior experience working with a leadership team Microsoft SharePoint - Administrating SharePoint Project Management experience Experience with Managed Care and / or with health plans Experience with regulatory auditsCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) 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. Job Keywords: performing analysis, reporting, operational support, Programming knowledge (reporting code) databases, structures, design, systems design, data management, data warehouse, SQL, Crystal Reports, queries, macros, data manipulation, Richmond, Virginia, VA,VAMLTSS
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.