Healthcare Quality Measurement Consultant, Data Analytics and Coding - Remote

UnitedHealth Group•Reston, VA

85d•$91,700 - $163,700•Remote

About The Position

Optum Serve Consulting/The Lewin Group (OSC/Lewin), a national health care and human services consulting and policy analysis firm, is seeking a Healthcare Quality Measurement Consultant focused on data analytics and coding. The consultant will support quality measurement work for federal, state, and other clients, applying policy, clinical, and technical expertise to evaluate and implement health care quality measures. The role includes hands-on analysis and coding of complex health data, measure development and testing, client consultation, business development, and project leadership. The position is remote within the U.S.; employees hired in the Minneapolis or Washington, D.C. area must work in the office at least four days per week. Remote employees must follow UnitedHealth Group’s Telecommuter Policy.

Requirements

At least 4 years of industry experience in health services research, evaluation, and/or policy, with solid analytical skills, and an advanced degree (M.D., D.O., master’s, or Ph.D.) in medicine, economics, health policy research, or a similar discipline; alternatively, a bachelor’s degree with at least 6 years of experience.
Experience leading business development and proposal response efforts, including engaging clients and partners.
Experience working on quality measure engagements, preferably for federal programs such as CMS programs.
Experience working with health care quality measurement data, including administrative claims, instrument-collected data, chart-abstracted data, or EHR output.
Experience collaborating with diverse teams, building consensus, and communicating with people of varying technical aptitudes and professional backgrounds.
Experience working with clinical EHR and/or claims data in a quality measurement context.
Demonstrated experience implementing or supporting eCQMs for CMS programs, such as IQR, MIPS, ACOs, or Innovation Center models.
Broad understanding of federal or state health policy issues and ability to serve as a subject matter expert in multiple areas.
Solid understanding of CMS quality measure specifications, including numerators, denominators, exclusions, and data completeness rules.
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 with complex structures and relationships, such as the Integrated Data Repository, Chronic Conditions Warehouse, or similar data environments.

Responsibilities

Evaluate evidence on the effectiveness of clinical measures derived from administrative or claims data, health records, electronic health records, and other data sources in compliance with CMS, AHRQ, and NQF requirements.
Extract, transform, analyze, and validate large health care 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 quantitative analyses to inform quality measurement for Medicare and Medicaid payment models.
Track activities of 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 client relationships through policy consultation and thought leadership.
Support organizational strategy and long-term growth in partnership with leadership.
Manage project delivery teams responsible for day-to-day execution.
Mentor team members in technical and analytical problem-solving skills.