Sr. Data Analyst - HEDIS Quality Measures

UnitedHealth Group•Detroit, MI

19h•$91,700 - $163,700•Remote

About The Position

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. Step into a high-impact Sr. Data Analyst – HEDIS Quality Measures role where data drives better health outcomes. In this position, you will serve as a key subject matter expert supporting dual Medicaid and Medicare programs, bringing deep knowledge of how these programs operate and the data that powers them. You will lead the generation and analysis of quality measure data, translating insights into actionable improvements across initiatives. Working closely with QIPD and Optum/DTMB partners, you will help coordinate efforts and establish sustainable, scalable processes that support ongoing program success. This is a dynamic, collaborative opportunity to apply your consultative expertise and make a meaningful impact on quality and performance across complex healthcare programs. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

5+ years of experience with Medicaid data, including the use of this data in generating quality measure results
Eligibility and Enrollment Data – experience and familiarity with eligibility and enrollment data to identify dual populations of interest
Claim Data – familiarity with Medicaid claims and encounters data; experience analyzing and understanding this data
Medical claims and encounters
Dental claims and encounters
LTSS claims and encounters
5+ years of experience and familiarity with Medicare data, including the use of this data in generating quality measure results for the dual Medicaid/Medicare population
Eligibility and Enrollment Data – experience and familiarity with eligibility and enrollment data to identify dual populations of interest
Claim Data – familiarity with Medicare claims and encounters data; experience analyzing and understanding this data
Medical claims and encounters
Pharmacy claims and encounters
5+ years of experience using SQL
5+ years of experience working with technical developers, end users/customers to strategize solutions to align with business requirements
3+ years of experience in Generation of Quality Measures – familiarity with quality measure specifications, including Medicare-specific measures utilized by dual populations
3+ years of experience facilitating business requirements gathering, technical documentation, test plan creation
3+ years of experience with all phases of SDLC

Nice To Haves

Ideal candidate would have experience in custom-coding quality measures, as well as utilizing commercial products to generate results
Experience and knowledge of the State of Michigan’s licensed commercial product, Symmetry EBM
Experience facilitating customer requirements gathering meetings/sessions/JAD Sessions, and analytical business value.
Ability to recognize, gather, correlate, and analyze facts, draw conclusions, define problems, and devise solutions and alternatives and make appropriate recommendations.
Business Analyst experience in a state government environment

Responsibilities

Provide subject matter expertise related to dual Medicaid/Medicare programs, including the data generated and utilized by these programs
Generate and analyze quality measure data and results for these projects and programs
Work closely with QIPD staff and current Optum/DTMB staff to coordinate activities and ensure sustainable processes are in place to support the needs of these programs on an ongoing basis
Provide consultative expertise related to the dual Medicaid/Medicare programs, including familiarity with how these programs run, and the data generated and utilized by these programs