Clinical Quality Analyst

Learn more about UnitedHealth Group
UnitedHealth Group

UnitedHealth Group

Clinical Quality Analyst

Las Vegas, NV
Full Time
Paid
  • Responsibilities

    POSITION DESCRIPTION

    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 CLINICAL QUALITY ANALYST will manage quality improvement initiatives and projects that focus on improving the health care and services for health plan members and to manage compliance with NCQA accreditation and state and regulatory requirements.

    PRIMARY RESPONSIBILITIES:

    • Work with the Associate Director and Manager of Clinical Quality to create and implement strategies, work plans, policies and procedures and documents to maintain compliance with state and federal regulatory requirements including the Centers for Medicare & Medicaid Services, state Medicaid and NCQA accreditation standards

    • Ability to use applied analytics to forecast and trend retrospective and prospective HEDIS® data

    • Design, create and implement Quality Improvement HEDIS projects and initiatives

    • Conduct and manage outcomes of various studies that may include analyzing, reviewing, forecasting, trending, and presenting information for quality planning and management needs

    • Provide analytical support and expertise when compiling and reporting information

    • Develop and present recommendations and alternatives for management and executive review

    • Assume responsibility for data integrity among various internal groups and/or between internal and external stakeholders

    • Lead and/or mentor associates

    • Assist in developing department strategic action plans including identification of objectives, goals and strategies

    • Develop, analyze and monitor new, routine and ad hoc reports using multiple data sources and systems

    • Report and analyze member care quality for the development of plans and programs to support continuous quality improvement using HEDIS and other tools

    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.

  • Qualifications

    REQUIRED QUALIFICATIONS:

    • Bachelor's degree
    • 3+ years of data analysis and reporting experience
    • Intermediate level proficiency with Microsoft Excel

    PREFERRED QUALIFICATIONS:

    • Degree in Healthcare Administration, Business or Analytical field
    • 2+ years of experience in a healthcare / managed care environment
    • 1+ year of experience working in a Quality Improvement department
    • Familiarity with NCQA regulations and HEDIS experience
    • Experience managing multiple projects

    CAREERS AT UNITEDHEALTHCARE EMPLOYER & INDIVIDUAL. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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.

  • Industry
    Hospital and Health Care
  • Fun Fact
    UnitedHealth Group is working to create the health care system of tomorrow.
  • About Us
    A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, we’re doing a lot of good for more than 142 million people worldwide.