SDS Clinal Quality Analyst - HEDIS - Remote EST / CST

Requisition Number: 2377228
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The SDS Consultant is responsible for ensuring the accuracy, completeness, and audit-readiness of Supplemental Data Source (SDS) documentation, with a primary focus on HEDIS Section 5 compliance. This role plays a critical part in supporting successful audit outcomes by reviewing, editing, and validating documentation, as well as coordinating remediation efforts and verification activities.
Work Location

• Telecommute (home-based)
• Must have reliable, hardwired high-speed internet (Wi-Fi not permitted)

Work Hours

• Standard day shift: 9:00 AM - 5:00 PM (EST or CST)

Team Environment

• Small, highly collaborative team of 4 professionals
• Focus on quality, compliance, and audit readiness
• Team culture emphasizes:
  • Accountability and responsiveness
  • Strong attention to detail
  • Continuous feedback and improvement

If you are able to work EST/CST schedule, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:

• Section 5 Documentation Review & Optimization
  • Conduct comprehensive reviews of Section 5 submissions for completeness, accuracy, and compliance with NCQA standards
  • Provide actionable feedback and detailed editing recommendations to improve documentation quality
• Audit Readiness & Compliance Support
  • Ensure all supplemental data sources meet audit standards and are properly documented
  • Identify risks, gaps, or inconsistencies and recommend corrective actions
• Stakeholder Communication & Follow-Up
  • Collaborate with internal teams to communicate required updates and track progress
  • Proactively follow up to confirm implementation of recommended changes
• Primary Source Verification (PSV)
  • Perform PSV activities, including chart reviews, for non-standard supplemental data sources
  • Validate data integrity and ensure adherence to audit requirements
• Data Tracking & Tool Management
  • Accurately enter and maintain data within the SDS tracking tool
  • Track Section 5 progress, PSV results, and auditor issue logs
  • Ensure timely resolution and proper documentation of all audit findings
• Issue Identification & Resolution
  • Monitor and manage auditor feedback and issue logs
  • Support root cause analysis and corrective action tracking

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.
Required Qualifications:

• 2+ years of HEDIS audit experience
• Experience with Section 5 documentation
• Experience with Supplemental Data Sources (SDS)
• Able to work EST or CST schedule

Preferred Qualification:

• Experience supporting NCQA audits

Core Competencies

• Exceptional attention to detail - ability to identify subtle discrepancies and ensure accuracy in documentation
• Strong written and verbal communication skills - clear, concise, and professional communication with stakeholders
• Responsiveness and accountability - ability to manage deadlines and follow through consistently
• Analytical thinking - ability to interpret audit requirements and apply them effectively
• Adaptability and quick learning - ability to rapidly understand tools, processes, and evolving audit requirements
• Technical Skills
• Experience working with audit tracking tools or data systems
• Proficiency in data entry, tracking, and documentation management
• Familiarity with healthcare data, coding, and chart review processes preferred

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.