Healthcare Quality Measurement Consultant, Data Analytics and Coding - Remote

UnitedHealth Group•Reston, VA

7d•$91,700 - $163,700•Remote

About The Position

Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors. OSC/Lewin provides both depth and breadth of expertise in the wide-ranging field of health human services consulting, with more than 250 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin’s core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction. At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. We are seeking a passionate, visionary, and growth-oriented leader who can deliver innovative solutions to our clients. The successful candidate for Healthcare Data Analytics Consultant, Quality Measurement will be an established and recognized thought leader with a solid track record in supporting quality measurement contracts and business development. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

Health policy professional with 4+ years of industry experience in health services research, evaluation and/or policy including solid analytic skills and advanced degree (M.D., D.O., Master’s degree, or Ph.D.) in medicine, economics, health policy research, or similar discipline OR a Bachelor’s degree with 6+ years of experience
Experience in leading business development and proposal response efforts, including engaging with clients and partners in the business development process
Experience working on quality measure engagements, preferably for federal programs, including those at CMS
Experience working with various types of data used to measure health care quality (e.g., administrative claims, instrument-collected data, chart-abstracted data, EHR output)
Experience collaborating with and building consensus with diverse teams ability to communicate with individuals of varying technical aptitudes and professional backgrounds
Experience working with clinical data from EHRs and/or claims data in a quality measurement context
Demonstrated experience implementing or supporting eCQMs for CMS programs (e.g., IQR, MIPS, ACOs, Innovation Center models)
Broad understanding of federal or state health policy issues, with ability to work in multiple areas serving as a subject matter expert
Solid understanding of CMS quality measure specifications, including numerators, denominators, exclusions, and data completeness rules
Proven ability to translate policy and measure specifications into technical requirements and implementation logic

Nice To Haves

Experience supporting multi-year quality measure development or implementation contracts
Experience with databases having complex structures and relationships, such as the Integrated Data Repository, Chronic Conditions Warehouse, or similar data environment

Responsibilities

Evaluate evidence on effectiveness for clinical measures derived from administrative or claims data, health records, electronic health records, other data sources in compliance with Centers for Medicare & Medicaid Services (CMS), the Agency for Healthcare Research and Quality, and the National Quality Forum (NQF) requirements
Perform hands-on coding to extract, transform, analyze, and validate large healthcare datasets using programming languages such as Python, SQL, R, or SAS.
Design and implement coding solutions that automate measure calculations, quality reporting processes, and value-based care performance analyses
Develop test measure protocols and measure specifications
Perform a broad range of quantitative analysis to inform quality measurement for Medicare and Medicaid payment models
Track activities of key standards-setting committees and consensus-based organizations such as NQF
Draft and manage proposals for new projects related to measure development, testing, maintenance, and implementation
Engage, develop, cultivate and expand new and existing client relationships through policy consultation and thought leadership
Support the continued development of existing strategy to fuel long-term organizational growth in partnership with organizational leadership
Manage project delivery teams responsible for day-to-day project execution
Mentor other team members to develop their technical and analytical problem-solving skills