HEDIS Project Manager - Telecommuting opportunity - Full-time / Part-time

No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm)

Are you a subject matter expertise in project management, scope definition, risk identification, methodology and resource allocation or facilitation? Assist us with strategic initiatives crossing business teams and operating groups as a Project Manager to coordinate and complete projects, define performance and results and manage vendors and service providers. You'll investigate non-standard requests and problems, makes presentations to senior leadership, ensure project documentation is accurate and ensure projects are completed on time and within scope. Pertinent data and facts will be reviewed to identify and solve issues and mitigate risks, prioritize your work load and work on ad hoc projects as assigned. Certification or in process of Certification for Project Management required and previous experience in a Project Management Office (PMO) is a plus.

Responsibilities:

• Managing HEDIS reporting project for multiple markets with year-round monitoring and annual required reporting. Supports state required Non-HEDIS quality management metric reporting where applicable


• Works with HEDIS Auditor(s) including managing onsite reviews and the collection and preparation of audit documentation. Including documentation and response to auditor requested data or process investigations


• Supporting Health Plans as Subject Matter Expert of NCQAs HEDIS Technical Specifications


• Working with Health Plans and vendors to review their programs and processes and develop data collection strategies for HEDIS/QM reporting. Reviews data systems related to reporting


• Coordinating with IT group the set-up of HEDIS measurement for market level reporting. This includes assessment of code mapping, provider specialty mapping, billing systems, member benefits and payment mechanisms; as well as providing analysis of impact on performance scores


• Performing data support and evaluation of performance by medical record review vendor(s)


• Extracting, manipulating, and interpreting data from HEDIS Software data repository


• Identifying and implementing opportunities to improve rates or efficiency of data collection / Identifying and reviewing claims data. Identifying alternative sources for administrative data


• Supporting the evaluation and monitoring of State specific QM Metrics


• Performing data completeness evaluations and ad hoc QM data studies


• Provides a high level of analytic support and manages large data sets

Required Qualifications:

• BA/BS degree in Accounting, Finance, Business or related field and/or equivalent education and experience


• 2+ years of project management experience


• 2+ years experience in tracking, planning projects, working with large data sets and making data-driven analytical decisions


• Intermediate level of proficiency with Excel and PowerPoint


• Demonstrated ability to communicate ideas clearly and concisely


• Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities

Preferred Qualifications:

• Intermediate level of proficiency with Access

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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.

Keywords: HEDIS, project management, Excel, Healthcare, audit, auditing, auditor, NCQA, Metrics, reporting, insurance