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in Minnetonka, MN

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Hours Full-time, Part-time
Location Minnetonka, MN
Minnetonka, Minnesota

About this job

Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As a HEDIS Project Manager 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. You'll act as a voice for our members, guiding the development of comprehensive care plans that will help others live healthier lives. Here's your opportunity to discover 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.  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. 


 


UnitedHealthcare Quality Management & Performance is an integrated team serving all UnitedHealthcare businesses. We're focused on improving the health of our members, enhancing our operational effectiveness and reinforcing brand and reputation for high-quality health plans. Join us and help guide our efforts to improve the patient experience. It takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment.


 


Primary 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

 

Requirements

Required Qualifications:




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

  • 2+ years experience working in a healthcare environment

  • 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.


 


Job Keywords: HEDIS, project management, Excel, Healthcare, audit, auditing, auditor, NCQA, Metrics, reporting, Managed Care, Medicaid, State Health Plans, Telecommute, Work from Home