Senior Clinical Quality Analyst Remote (In Florida Only)

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.

If you are located in Florida, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Provide support to health plan customers by responding to customer requests, anticipating issues and problem solving within the quality role
• Develop and support quality improvement activities and performance improvement plans by:
  
  
  
  • Gathering data from available resources and analyzing data
  • Preparing written reports and annual core documents for internal teams and customers
  • Presenting analyses to customers and working collaboratively to improve the member experience
  
  
  
  
• Assisting in developing department strategic action plans including identification of objectives, goals and strategies
• Participate in designing, creating, implementing and managing quality improvement projects and initiatives in support of the behavioral health measures (HEDIS, other), working collaboratively with health plan customers and other teams when appropriate
• Regularly meet with health plan customers to develop and present reports including data, analysis, activities and improvement initiatives
• Support ongoing monitoring and compliance with QM Policies and Procedures and prepare documents appropriate to meet national and customer NCQA and URAC accreditation standards
• Interface with key departments, as necessary, in order to identify barriers, opportunities and interventions to improve performance on priorities
• Assume responsibility for data integrity among various internal groups and/or between internal and external sources and escalate any issues found in the data
• Develop, analyze and monitor new, routine and ad hoc reports using multiple data sources and systems
• Participate in preparation of materials and evidence necessary for PIPs and audits related to BH QM as needed
• Assist with preparation and facilitation of BH committees and workgroups
• Actively participate in relevant department and essential QM Committee meetings and workgroups in order to implement QM Program
• Organize IHI projects and manage outcome data of various interventions that may include analyzing, reviewing, forecasting, trending and presenting information for quality management planning and management needs
• Support the UHC Florida C&S plan through collaboration with other staff within the scope of the quality role

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:

• Bachelor's degree in behavioral health or related field
• 3+ years of experience in a health care setting
• 2+ years of experience in managed care, including Medicaid
• 2+ years of experience with performance improvement projects or using data to develop intervention strategies to improve outcomes
• 1+ years of experience collecting, analyzing and presenting data
• Experience managing projects, including multiple projects simultaneously
• Knowledge and experience with national QI standards (NCQA, HEDIS)
• Intermediate computer skills (Outlook, Microsoft Word, Excel, and PowerPoint) with the ability to navigate a Windows environment
• Proven presentation skills (present reports to health plan customers, leaders/colleagues)
• Proven ability to work independently
• Access to high-speed internet services along with space for home office set up
• Resides in Florida

Preferred Qualifications:

• Master's degree in behavioral health or related field
• Six Sigma, IHI, or other Quality Certification
• Behavioral health related licensure
• Experience creating reports related to quality improvement / performance outcomes

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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.