Senior Manager, Business System Analysis - Remote

UnitedHealth Group•Eden Prairie, MN

5d•$112,700 - $193,200•Remote

About The Position

This position is responsible for the overall completeness and timeliness of UHC/OptumCare clinical ambulatory and hospital data from Providers and vendors. The goal of the role is to drive HEDIS toward a 5 Star Rating for all contracts and data submission types, which includes all data from provider and vendor entities (Ambulatory, Facilities, Labs, HIEs, etc). 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

5+ years of clinical data analysis experience
Member encounter/clinical data experience
Experience in working with HL7 and FHIR clinical data standards
Understanding of HIPAA and PHI compliance
Proficient in understanding HEDIS requirements as it relates to data submissions and performance
Proficient at using SharePoint, Rally, and Service Now
Demonstrated ability to manage multiple clinical submitter implementations at one time
Demonstrated ability to adapt to a fast-paced, quickly changing environment
Demonstrated ability to effectively implement and lead change management
Proven solid communication skills
Proven solid leadership skills
Proven client relationship management skills

Nice To Haves

Technical and business experience regarding clinical quality specifications with the ability to speak with confidence
Provider-facing experience
EHR/Vendor system experience
General understanding of CMS Stars ratings and HEDIS

Responsibilities

Partnership with the Market/Business Leasers (UHC/OptumCare)
Must be able to cultivate Solid Partnership with UHC all Lines of Business Operational Peers
Works as a technical liaison in cohesion with operational counterpart to execute acquisition of data from providers, specialists, and other entities
Leads cross functional efforts on the technical side for process improvement and communication to data acquisition team leadership
Directly involved with elevated, prioritized provider group issues to help resolve and drive solutions for data collection
Monitors, Reports, and communicates process flow for intake of data and timeliness of processing
Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data
Manage issues by proactively reporting progress and working with cross functional peers to resolve
Serve as Provider Data Acquisition SME to internal local teams and external providers for all data acquisition processes
Serve as market SME to campaign leaders ensuring campaigns meet local market requirements and nuances
Oversight and project management responsibilities for the successful implementation of clinical data exchange implementations with key providers (may include capturing data from various data sources including EMR (Electronic Medical Record), HIE (Health Information Exchange), data marts, etc.)
Manage implementations through effective use of project plan and project management discipline
Engage with providers to discuss requirements and process for setting up clinical data exchanges
Collaborate with market management to identify and engage key providers to collect member encounter and clinical data
Lead cross-functional teams to drive projects to completion within committed timelines
Communicate effectively to manage expectations of clients and providers
Provide timely and accurate progress updates and reporting related to current project status for each implementation
Identify, manage, and mitigate risks and issues impacting implementations
Participate in development, maintenance, and improvement of implementation processes