STARS Healthcare Analyst - Remote
Company: UnitedHealth Group
Location: Hartford
Posted on: May 10, 2022
Job Description:
You'll enjoy the flexibility to telecommute* from anywhere
within the U.S. as you take on some tough challenges. 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's improving the
lives of millions. Here, innovation isn't about another gadget,
it's about making Healthcare data available wherever and whenever
people need it, safely and reliably. There's no room for error.
Join us and start doing your life's best work.SMThe Medicare Stars
Analytics Consultant position will audit (research, analyze and
report) various aspects of the STARS data flow to ensure the
highest level of data quality, data reporting, data analytics, and
4 Star or better annual ratings. The position will work with
internal and external businesses, as well as technology
constituents to understand and validate data and processes.Optum
Care Services focuses on ISNP, Optum At Home DSNP, HouseCalls, and
Post-Acute programs for internal and external clients. The role
will support the STARS audit process for Optum Complex Care
Management members. This audit process will focus on all CCM
Clinical Programs (HouseCalls, ISNP, IE-SNP, DSNP Optum at Home 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 HEDIS and Stars gap closure, 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 through the use of
data analytics, technology, workflow changes, reference material,
and clinical support.You will have responsibility for creating
relationships with key cross-functional stakeholders, including
clinical, product, Optum IT, reporting, network, and operations to
ensure awareness of and reliance on Stars Analytics subject matter
expertise and validation of existing and proposed data used for
Stars and HEDIS measures. Work across the business areas to ensure
alignment of data and reporting for internal and external clients.
Build relationships and work effectively in a matrixed environment
with internal and external business partners. Example:
UnitedHealthcare Star Analytics and HEDIS teams, Operations,
Product, Optum IT, Market leadership, Finance, Compliance, Network,
and external clients. With Optum IT to document and translate
business requirements. Validates, audits, and evaluates reporting
and analytics for clinical quality and Stars reporting.Use
technical skills to manipulate data using SQL, SAS, Tableau, Excel,
SSRS, Teradata, or other tools to provide actionable information to
internal customers in support of their business goals by product
line. - Help build reporting and data visualizations to create data
driven analytics that drive strategies and measure interventions to
ensure plans achieve 4+ Star goals.This position is full-time (40
hours/week) Monday - Friday. Employees are required to work our
normal business hours of 8:00am - 5:00pm. It may be necessary,
given the business need, to work occasional overtime or weekends.
*All Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy.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
standardYou'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:
- High School Diploma / GED (or higher)
- 3+ years of experience in Health Care Analytics
- 1+ years of experience working in Medicare Star Ratings
- 2+ years of experience with analytics/visualization tools: SSRS
and/or Tableau
- 2+ years of experience with database tools: SQL, SAS and/or
similar data manipulation tools
- 3+ years of experience with process improvement, workflow,
benchmarking and / or evaluation of business processes
- Knowledge in MEDICARE Star Rating methodology
- Ability to interpret HEDIS/clinical quality measure
specifications
- Proficient with Microsoft software programs - Microsoft Word
(create and edit correspondence), Microsoft Excel (ability to
create, edit, and sort spreadsheets, basic analytical formulas
(VLOOKUP, if), Microsoft PowerPoint (ability to create and edit
slides), Microsoft Outlook (email and calendar management), and
Microsoft Visio (ability to create, edit, save, and send
presentations)Preferred Qualifications:
- Master's Degree (or higher) 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
- Experience and expert level knowledge in HEDIS operations, with
extensive knowledge of specifications, reporting methodology,
Medical Record Review operations, supplemental data integration,
and HEDIS reporting requirementTelecommuting Requirements:
- Required to have a dedicated work area established that is
separated from other living areas and provides information
privacy
- Ability to keep all company sensitive documents secure (if
applicable)
- Must live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing
high-speed internet serviceSoft Skills:
- Skilled in communication and keeping teams updated
- Ability to work in a fast paced, complex organization
- Strong interpersonal skills and ability to interact
collaboratively with internal business partners across multiple
departments and business segmentsUnitedHealth Group requires all
new hires and employees to report their COVID-19 vaccination
status.Military & Veterans find your next mission: We know your
background and experience is different and we like that.
UnitedHealth Group values the skills, experience and dedication
that serving in the military demands. In fact, many of the values
defined in the service mirror what the UnitedHealth Group culture
holds true: Integrity, Compassion, Relationships, Innovation and
Performance. Whether you are looking to transition from active duty
to a civilian career, or are an experienced veteran or spouse, we
want to help guide your career journey. Learn more at Learn how
Teresa, a Senior Quality Analyst, -works with -military veterans
and ensures they receive the best benefits and experience possible.
-Careers with Optum. Here's the idea. We built an entire
organization around one giant objective; make the health system
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.SMColorado, Connecticut or
Nevada Residents Only: The salary range for Colorado residents is
$79,700 to $142,600. The salary range for Connecticut / Nevada
residents is $87,900 to $156,900. 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.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,
UnitedHealthcare, Optum, health care, office, phone support,
customer service, billing, training class, now hiring, jobs,
career, work at home, work from home, WAH, WFH, remote,
telecommute, hiring immediately, #RPO
Keywords: UnitedHealth Group, Hartford , STARS Healthcare Analyst - Remote, Professions , Hartford, Connecticut
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