Clinical Quality Analyst - Brentwood, TN

In your field, learning never stops. And neither do you. You are continually pushing yourself to reach higher and go further. For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care while doing your life's best work. (sm)
 
***In office with potential Work from Home after 3 months*** 
 
There's energy and excitement here, a shared mission to improve the lives of others as well as our own. Are you ready for a new path?  This position will support the Dual SNP (DSNP) program. The position is responsible for strategically developing clinically oriented provider and community based.
 
Primary Responsibilities:

Uses pertinent data and facts to identify and solve a range of problems within area of focus or expertise
Mine claims and case management software for data to assist in the development of preventive care programming as well as determine outcomes of implemented programs
Investigates non-standard requests and problems, with some assistance from others
Prioritizes and organizes own work to meet deadlines
Provides explanations and information to others on topics within area of expertise
Solves moderately complex problems and / or conducts moderately complex analyses
Works with some guidance; seeks guidance on only the most complex tasks
Translates concepts into practice
Provides explanations and information to others on difficult issues
Acts as a resource for other STARS Quality Analysts with less experience
Some proficiency in understanding of basic process management and total quality management principles and methodologies (e.g., Six Sigma; Lean)
Demonstrate understanding of relevant organizations' operations, products and applications, strategies, processes, and / or business priorities in order to build effective solutions
Some proficiency in understanding of upstream and downstream impacts to partners of business process operations and solutions
Engage and often directly support Quality auditing activities to validate process performance
Support the analysis of quality auditing findings as it relates to business process information (e.g., metrics; analytics) to identify key issues, trends, and potential root causes (e.g., training issues; lack of understanding by user community) that point to improvement opportunities
Support engagement with relevant stakeholders (e.g., end users; SMEs; sponsors) to establish appropriate criteria and goals (e.g., efficiency; effectiveness) in order to direct investigation into problems and potential solutions
Support the estimation and / or quantify potential benefits, costs, and resource requirements associated with recommended business process solutions
Support the summarization and communication of proposed solutions with the appropriate audiences in a manner tailored to their understanding, level, or experience
Support the communication of potential impacts and risks associated with implementing proposed solutions, progress of actions taken to resolve risks and gaps identified
 

Required Qualifications:

Undergraduate degree or equivalent experience
Intermediate to expert with MS Office including Word, Excel and PowerPoint and Access
Intermediate to expert SharePoint experience including utilization and site maintenance
Intermediate or Expert Visio experience (or like software)
Dynamic verbal and non-verbal communicator who can create and maintain a collaborative work environment with critical business partners including executive leadership Strong analytical and negotiation skills with a proven track record for innovative successful outcomes
Proven record of positive, effective coaching and development ability as well as supporting effective team interactions
Preferred Qualifications:

Prior experience with HEDIS preferred
Prior experience with Health Insurance industry
2+ years in a role supporting a quality function or related operational function preferred
1+ years of project management experience
 
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SM
 
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.
 
 
Job Keywords: Analyst, Quality Analyst, Quality, Data Analyst Health Care, Medicaid, Medicare, HEDIS, NCQA, Managed Care,  Work at Home, Brentwood, TN
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