CDQI Business Analyst (Telecommuter Option) - Full-time / Part-time

This position will report into the CDQI Process Improvement Associate Director and will be responsible for supporting strategic process  improvement  initiatives around Risk Adjustment & Quality across Optum Local Care Delivery.

• Quality Initiatives:




• HEDIS/STAR tool


• Gaps in care


• HEDIS/STAR programs


• Risk Adjustment Initiatives:




• Best practices for provider engagement


• Provider incentives


• Member engagement


• Embedded clinical model


• Equipment & Screenings


• Training programs


• Compliance programs

• Working in a matrix environment to drive efficiencies through influence


• Seeks ways to improve job and operational efficiency and makes suggestions as appropriate


• Takes ownership of the total CDQI process and provides constructive information to minimize problems and increase provider and market satisfaction.


• Partners with Local Care Delivery leadership teams and Optum management across markets to coordinate execution and implementation in all markets.


• Ensure activities are appropriately integrated into the strategic direction, as well as the mission and values of the company. 

• Bachelor's degree or greater or equivalent experience


• 2+ years combined experience within managed care/health insurance industry experience in government relations, network management, and/or legal/compliance


• 1+ years of previous Business Analysis experience


• 2+ years of previous data analysis, process documentation, and process improvement experience


• 1+ years of previous experience interacting with business leadership


• 30% travel required

• Familiarity with government pay for performance programs a plus


• Experience in risk adjustment


• Experience in Quality with a working knowledge of HEDIS


• Strong knowledge of CMS Risk Adjustment and ICD-9 coding requirements and regulations.


• Lead a complex or multifunctional/multi-location team/organization


• Six Sigma certification and/or exposure


• Proven experience managing organizational growth and change


• Well-honed communication skills (both written and verbal)


• Ability to build strong relationships across a variety of stakeholders


• Proficiency with Microsoft Office 

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.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.