Description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

Supplemental Data Operations is dedicated to the evaluation and management of supplemental data sources (SDS) including efficacy evaluation, coordination of auditor approvals and documentation, as well as development of requirements documentation for all supplemental data sources. The team collaborates with the ECDP team, Quality Optimization and Insights, ECDH, ECP and other appropriate areas of the business, to ensure the most efficient management of data for the greatest Enterprise gain. All work supports Commercial, Medicare & Medicaid quality improvement programs. This role will report to the Technology Operations however will have dedicated responsibilities to support supplemental data operations.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. The position may telecommute however work hours are either Central or Eastern Time zones.

Primary Responsibilities:

• Source Management
  • Identify opportunities to improve data quality within data sources
  • Collaborate with team to support development of action plans to implement data quality improvements
  • Serve as a liaison to quality partners to consult regarding SDS data requirements
  • Conduct primary source verification performed for supplemental sources (internal and external, including pre-prod PSV during implementation) - year round
  • Ensure data completeness and identify required updates (end to end reporting/validation)
• Data Management
  • Identify the best means of managing data exchange across internal teams
  • Coordinate with key internal departments (ECDP, ECDH, ECP) and other teams to implement new SDS development
  • Monitor file loads for all sources for anticipated volumes of records
  • Monitor SDS efficacy/impact for anticipated measure impact
    • Research situations where impact is not being experienced as expected
    • Research situations to validate if impact is higher than anticipated to ensure accuracy
    • Develop projects and plans across various teams to engage in solutions as needed
  • Evaluate coding against annual technical specification changes and communicate findings to stakeholders during month of technical specification release
  • Communicate requirement changes for any changes in SDS reporting to data team developing reports
    • QA changes
    • Validate report production
  • Manage & validate data backouts, when required
  • Conduct source reconciliation in SDS Tracker
  • Ensure data load lists are obtained and flowing to data team preparing file comprehensive load reporting
  • Manage data source list and crosswalks to support reporting and operations
  • Develop & maintain data processing schedule
  • Assess submitter data for existence
  • Incorporate benchmarking techniques for data validation
  • Review trends of monthly prospective data runs to identify data issues
  • Assess, produce and/or develop moderately complex relevant, standard or custom information (reports, dashboards, interactive reporting, charts, graphs and tables) from various data sources by querying data and generation the associated output
  • Summarize effectively data findings after research and create visualizations fit for purpose
  • Develop SDS Tool, maintain and continue to enhance functionality to execute department goals
  • Complete efficacy reports and ensure accuracy, explain variances as needed
  • Manage & validate data backouts, when required
  • Conduct source reconciliation in SDS Tracker for Audit submitted/approved vs SDS Impact
  • Complete complex research requests related to SDS
  • Ensure data load lists are obtained and flowing to data team preparing file comprehensive load reporting and assess vs. efficacy
  • Manage crosswalks to support reporting and operations
  • Rate trending/tracking
  • Assessment of submitter data - existence - benchmarks for data

Audit Management

• Maintain metrics pertaining to SDS
• Maintain documentation required to support use of supplemental data for HEDIS® for auditors and internal requirements
• Participate in audits as needed
• Participate in all source validation efforts

Other Responsibilities

• Participate in Staff and SDO work group meetings
• Complete responsibilities as assigned in work plan associated with maintaining and obtaining supplemental data, managing auditor requirements and associated documentation and oversight of business partner inputs and outputs
• Complete work on time, especially as it pertains to HEDIS® auditor deadlines
• Act as the Audit Liaison for SDO
• Assesses and interprets customer needs and requirements
• Translate requirements into technical specifications
• Develop & produce ad-hoc reports
• Use pertinent data and facts to identify and solve a range of problems within area of expertise
• Works with minimal guidance; seeks guidance on only the most complex tasks
• Support national projects /pilots
• Stay current with new technology / data sources being developed within UnitedHealth Group
• There may be circumstances where these responsibilities vary by line of business

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:

• 5+ years of experience with data analytics and reporting
• 3+ years of experience in Healthcare Industry with Quality/Process Improvement focus with understanding of medical terminology and clinical care
• 2+ years proficiency with R, Python, SQL, Dashboarding including complex query writing
• 1+ years of demonstrated success with project management
• Advanced MS Excel and MS Access skills
• Proficiency with MS Office (Including Word, Outlook, PowerPoint, Visio)
• Proven problem-solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
• Proven excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
• Able to work EST / CST schedule

Preferred Qualifications:

• 1+ years of experience with HEDIS® documentation
• 1+ years of experience with auditing processes
• Understanding of data gathering/analysis
• Comprehensive understanding of HEDIS® requirements
• Proven ability to learn new technologies
• Proven project management skills

Soft Skills:

• Solid interpersonal skills
• Ability to work on assigned tasks independently
• Team player who can influence change
• Solid communication skills
• Organized
• Ability to manage multiple projects at a time

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.