Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
As a member of the HEDIS Strategy and Technical Capabilities team, this position will have oversight of end-to-end Stars program execution related to EMR (Electronic Medical Record) capabilities and HEDIS compliance. This role will be responsible for leading EMR configurations and integration in alignment with HEDIS technical requirements by providing Stars and HEDIS subject matter expertise.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Stars Program and EMR HEDIS Compliance
Own end-to-end Stars EMR compliance processes including data ingested to the EMR, documentation in the EMR, and data out of the EMR
Ensures alignment of EMR capabilities with CMS and NCQA requirements
Monitor and assess EMR data quality and provide guidance to internal teams and clients to close gaps in care
Collaboration with cross-functional partners including Technology, Account Management, and Markets
Client-Facing Subject Matter Expert
Act as the subject matter expert for Star measures and EMR integration across internal and external stakeholders
Present complex information in a clear, client-friendly manner to support data-driven decision making
Lead regular client touchpoints to provide performance updates, action plans, and optimization opportunities
EMR Implementation and Ongoing Maintenance
Lead implementation of new clients and EMR systems, ensuring seamless integration with internal platforms
Serve as the primary liaison for client technical and operational teams during implementation
Provide ongoing support and troubleshooting related to Stars EMR process, including data ingestions, mapping, and measure tracking
Facilitate EMR capability assessments and offer strategic recommendations to improve performances
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 CMS Star Rating program experience in healthcare quality programs
2+ years of experience in program or project management demonstrating proficiency in handling multiple projects – including prioritization, planning, and task delegation
Experience with NCQA HEDIS technical specifications and clinical data abstraction workflows
Intermediate Excel skills with the ability to perform functions such as a VLookup
Proven ability to meet commitments, build consensus, and garner respect from other teams
Proven ability to assist with focusing activities toward a strategic direction and achieve target/goals
Preferred Qualifications:
PMP or equivalent project management certification
Experience with data analytics platforms or healthcare quality reporting tools such as PowerBI, SQL
Experience in maintaining EMRs from a HEDIS perspective
*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 $110,200 to $188,800 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.
UnitedHealth Group
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