Quality Clinical Analyst

UnitedHealth Group•Las Vegas, NV

5d•$29 - $52•Remote

About The Position

The Quality Clinical Analyst supports quality improvement initiatives with a focus on maternal/child health and behavioral health, value-based programs (VBP), provider engagement, reporting, and quality assurance initiatives. This role analyzes clinical and operational data, maintains Key Performance Indicator (KPI) dashboards, prepares presentations, manages and supports “Alternate Payments Contracts/ Models- Learning and Action Network/Value Based Program” (APC-LAN/VBP) deliverables, and coordinates program communications to improve outcomes, provider performance, HEDIS® compliance, and Nevada market quality and state goals. If you are located in Las Vegas, NV, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

2+ years of Data analysis, reporting, and performance monitoring
2+ years of Project organization, documentation management, and process improvement support
2+ years of experience project coordination, organization, deadline management, communication, and collaboration skills
Advanced proficiency with Microsoft Excel, Power Query, formulas, filters, pivot tables, and data tracking tools
Advanced proficiency Adobe Acrobat and Microsoft Office applications to support documentation, reporting, and presentation development
Advanced Proficiency with Power Point - Ability to develop polished, professional presentations for leadership, committees, state, and stakeholder audiences

Nice To Haves

Experience in healthcare quality, Medicaid, managed care, population health, maternal health, behavioral health, or provider engagement
Knowledge of case management systems, electronic medical record navigation, claims systems, HEDIS® chart review, and secure file transfer protocols within a healthcare environment
Experience using Power BI and Adobe Workfront/MOTE preferred
Strong attention to data accuracy, clear communication, and cross-functional collaboration

Responsibilities

Manage and support quality improvement, population health, value-based program, provider communication, quality assurance, state-required programs, and APC-LAN initiatives
Coordinate APC-LAN activities for assigned facilities, behavioral health providers, and OB-GYN practices, including benchmark reporting, provider performance tracking, and quarterly Joint Operating Committee (JOC) support
Support High-Risk Maternal Case Management, Value-Added Services, value-based program reporting, provider communications, and quality assurance requirements
Facilitate quality improvement program workstreams, including value-added benefit reporting, intervention tracking, workgroups, committees, and performance improvement initiatives
Analyze clinical, operational, productivity, and maternal health reports to identify trends, gaps, opportunities, and workflow improvement needs
Monitor population health interventions, program goals, and Medicaid maternal and child health contractual requirements
Develop and maintain KPI dashboards to support leadership review, performance monitoring, and data-informed decision-making
Apply report findings to support compliance, regulatory standards, and quality improvement action planning
Develop and maintain presentation materials for maternal health, OB, provider, quality improvement, committee, leadership, state-contracted, and stakeholder meetings
Summarize data, trends, barriers, risks, interventions, and outcomes in a clear, concise, and professional format
Prepare presentation decks that support performance review, opportunity identification, and improvement strategy discussions
Monitor internal and external communications, including email and call lines, to ensure timely routing, follow-up, and documentation of inquiries
Support the development of program, presentation, and project materials for internal and external stakeholders, provider and member audiences, and state-contracted communications
Ensure all communication materials are high level, accurate, professional, timely, and aligned with program priorities
Create and maintain Word documents, PowerPoint presentations, Excel trackers, project timelines, action item logs, report summaries, dashboards, meeting materials, and audit-ready records
Use Excel formulas, filters, pivot tables, conditional formatting, data validation, and reporting logic to support analysis, tracking, dashboard updates, and process improvement
Use AI tools to assess work products and workflows for automation, augmentation, and enhancement opportunities