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Home and Community - Medicare Stars Healthcare Analysis - Telecommute

Company: UnitedHealth Group
Location: Orlando
Posted on: September 24, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) The Medicare Stars Analytics Consultant position will research, analyze, compile, and report out on various aspects of the Stars data flow to ensure the highest level of data quality, reporting, and analytics to obtain 4 Star or better annual ratings for the contracts we support. The position will work with internal and external business partners to understand, create, and validate our data and processes. Stars Analytics focuses on Optum At Home (OAH), Senior Community Care (SCC), HouseCalls, and Post-Acute programs for internal team members and external business partners. The role will support the Stars audit process for Optum Home and Community Care membership. This audit process will focus on all H&C Clinical Programs (OAH, SCC, HouseCalls, and Post-Acute Care). All aspects of Stars data flow will be in scope from documentation in EMR to Supplemental Data to data submission to prospective/retrospective HEDIS engines. In the Medicare Stars Analytics Consultant role, you will be accountable for improvement on Star measure gap closures, coding accuracy, data validations, transformation documents, facilitating effective reporting, consulting between internal and external teams, proactively identifying performance improvement opportunities, and being a subject matter expert on all things Star Ratings using data analytics, technology, workflow changes, reference material, and clinical support. The Medicare Stars Analytics Consultant will have the responsibility of creating relationships with key cross-functional stakeholders, including clinical, product, Optum IT, reporting, network, business partners, and market operations to ensure awareness of and reliance on Stars Analytics subject matter expertise and validation of existing and proposed data used for Star measures. The Medicare Stars Analytics Consultant will also work across the business areas to ensure alignment of data and reporting for internal and business partners, build relationships, and work effectively in a matrixed environment. The Medicare Stars Analytics Consultant will use technical skills to manipulate data using SQL, SAS, Tableau, Excel, SSRS, Teradata, PowerBI, and other tools to provide actionable information to internal and external customers in support of their business goals by product line. As well as help build reporting and data visualizations to create data driven analytics that drive strategies and measure interventions to ensure plans achieve the 4+ Star Rating or higher goal. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:

  • Research and analyze the data and processes associated with quality measure data from existing EMR platform which feed the supplemental data process
  • Understand HEDIS and NCQA technical specifications and apply measure criteria
  • Collaborate with internal analytics teams to understand clinical quality data flows: create alignment on data analytics methodologies used, identify and resolve data issues as they arise, and coordinate projects to implement changes
  • Serve as a key resource to conduct internal data audits, develop analysis and documentation to support findings, present summary to technical teams and leadership
  • Collaborate with internal cross functional teams to assist in the development and review of business and technical requirements
  • Lead and drive work streams to enhance short and long-term clinical quality reporting activities
  • Confident customer-facing approach: can defend analysis, can take input / feedback, and can consultatively say no by providing a range of alternatives, particularly those promoting a standard approach 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 in Health Care Analytics
    • 2+ years of experience with relational database tools: SQL / SAS / DBeaver / Teradata (at least one or combination of)
    • 2+ years of experience with analytics/visualization tools: Tableau / PowerBI / SSRS (at least one or combination of) Preferred Qualifications:
      • Master's degree in related fields
      • 5+ years of experience in Health Care, Understanding of Medicare Advantage
      • 3+ years of experience working in Stars at a large national plan
      • 1+ year(s) of experience working in Medicare Star Ratings
      • Deep knowledge in Star Rating methodology such as CAI, Improvement Factor, and Disaster logic
      • Ability to interpret technical specifications for individual Star measures
      • Skilled in communication both laterally and above
      • Ability to work in a fast paced, ever changing, regulated, and complex organization
      • Ability to interact collaboratively with internal and external business partners across the organization
      • Ability to think critically about vague issues and leverage problem solving skills to find solutions To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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. *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.

Keywords: UnitedHealth Group, Orlando , Home and Community - Medicare Stars Healthcare Analysis - Telecommute, Healthcare , Orlando, Florida

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