DSNP Sr Clinical Quality Analyst - Telecommute, Iowa
March 10, 2018
Des Moines, Iowa
For you, quality counts. For UnitedHealthcare, part of the UnitedHealth Group family of businesses, delivering quality care starts with processes and documentation standards that are the best in our industry. As a Senior Clinical Quality Analyst, you'll be a force for positive change, guiding the development of comprehensive care plans that will help others live healthier lives. Join us and help guide our efforts to improve the patient experience. If you are located in Iowa, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Educates providers and office staff on proper coding and billing practices, HEDIS and state-mandated quality metrics specifications, provider profiling and pay for performance measurement and medical record review criteria Solicit identification of barriers the office faces in providing care to members Supports the HEDIS medical record chase to support optimum HEDIS and quality metric reporting Design, create and implement quality improvement projects and initiatives Conduct and manage outcomes of various studies that may include analyzing, reviewing, forecasting, trending and presenting information for quality management planning and management needs Develop and present recommendations and alternatives for management and executive review Assist in developing department strategic action plans Develop and implement effective analysis, research and evaluation of quality management metricsIn addition to fostering teamwork and collaboration, much of your work will involve data extraction. Strong auditing skills are essential. You'll also need the communication and persuasion skills to deal with clinical and non-clinical audiences.
Required Qualifications:Bachelor's Degree or equivalent work experience 3+ years of health care experience Experience working with Medicare DSNP/STARS 3+ years' experience extracting data in SQL/Oracle environment Ability to navigate Microsoft Access Databases and VBA 2+ years experience developing and implementing performance improvement projects or using data to develop intervention strategies to improve outcomes Ability to collect, analyze and present dataPreferred Qualifications:Experience creating reports related to quality improvement/performance outcomes Experience with quality measures such as HEDIS/STARS Unrestricted and active RN licenseIf you're the kind of thinker and leader who wants to bring your contribution to a new level every day, here's your opportunity to do your life's best work.(sm) *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. Job Keywords: Clinical Quality Analyst, Quality Analyst, RN, Registered Nurse, HEDIS, STARS, DSNP, Medicaid, Medicare, managed care, SQL, Oracle, Access, VBA, quality improvement, data analytics, Bachelor's degree, Telecommute, Des Moines, Davenport, IA, Iowa, telecommute, telecommuter, telecommuting, remote
Internal Number: 746718
About UnitedHealth Group
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.