Senior Value-Based Healthcare Data Analyst - Remote

UnitedHealth Group•Pearland, TX

8h•$91,700 - $163,700•Remote

About The Position

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The Senior Value-Based Healthcare Data Analyst is responsible for providing leadership and advanced analytical expertise to support healthcare quality, regulatory, and operational reporting initiatives, including HEDIS, EDPS, and encounter submissions. This position ensures accuracy, integrity, traceability, and compliance of complex, multi source healthcare data in accordance with NCQA, CMS, and state regulatory requirements. The role functions as a hands on technical leader, supervising analytic activities and coordinating efforts across Quality, Clinical, Informatics, IT, and Business Intelligence teams. Through collaboration and data driven insights, the position supports organizational objectives related to quality performance, affordability, and improved member outcomes. If you are located in Texas, you will have the flexibility to work remotely as you take on some tough challenges. 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.

Requirements

Bachelor’s degree in Health Informatics, Healthcare Administration, Data Analytics, Statistics, Computer Science, Information Systems, Mathematics, or a related discipline
3+ years of experience in healthcare data analytics, informatics, decision support, or managed care, including project leadership or analyst mentoring
Experience supporting NCQA HEDIS Compliance Audits, quality measurement, and value-based care programs
Experience supporting Medicare Advantage (Part C) and/or Health Insurance Marketplace products
Experience extracting, reconciling, and validating data from EPIC Clarity and/or Caboodle
Solid experience with data validation, ETL processes, and healthcare reporting tools (eg, Tableau, Power BI, Crystal Reports)
Knowledge of Medicare Advantage, including Stars, HEDIS, and regulatory reporting programs
Advanced expertise in healthcare data analytics, quality measurement, and regulatory compliance
Understanding of HEDIS Technical Specifications, NCQA requirements, and related compliance standards
Proficiency working with claims and clinical data, including ICD 10 CM and CPT/HCPCS coding standards and healthcare data models
Advanced proficiency in SQL and Microsoft Excel, with working knowledge of Word and PowerPoint
Demonstrated ability to translate complex healthcare data into clear, executive level insights that support quality and performance strategy
Demonstrated ability to manage multiple priorities in a fast paced, deadline driven environment
Proven verbal and written communication skills with exceptional attention to detail and analytical rigor
Proven independently monitors data pipelines, submissions, and measure results for anomalies, gaps, or logic errors

Nice To Haves

Master’s degree in health informatics, Data Science, Analytics, Biostatistics, Healthcare Administration, or related field
Relevant certifications such as CPHQ, RHIA/RHIT, Epic (Clarity/Caboodle/reporting), CAP, or SAS/SQL/data analytics
3+ years of experience with EDI encounter data (837), acknowledgments (277CA/999), and CMS risk adjustment files (MAO 002/004, RAPS)
Experience reviewing work and providing actionable feedback
Solid expertise in healthcare analytics, quality metrics, and value-based care models
Advanced knowledge of Epic Clarity architecture, refresh cycles, and EDW integration for BI/reporting
Proficiency in Python, R, SAS, or similar programming/statistical tools
Demonstrated ability to balance strategic thinking with hands-on execution
Proven problem-solving skills with a focus on continuous improvement and proactive solution development

Responsibilities

Providing leadership and advanced analytical expertise to support healthcare quality, regulatory, and operational reporting initiatives, including HEDIS, EDPS, and encounter submissions.
Ensuring accuracy, integrity, traceability, and compliance of complex, multi source healthcare data in accordance with NCQA, CMS, and state regulatory requirements.
Functioning as a hands on technical leader, supervising analytic activities and coordinating efforts across Quality, Clinical, Informatics, IT, and Business Intelligence teams.
Supporting organizational objectives related to quality performance, affordability, and improved member outcomes through collaboration and data driven insights.
Monitoring data pipelines, submissions, and measure results for anomalies, gaps, or logic errors.