Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together.
This position is responsible for overall completeness and timeliness of UHC/OptumCare clinical ambulatory and hospital from Providers and vendors with a goal of the role 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.
Primary 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
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:
- 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
Preferred Qualifications:
- 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
*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 $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
Skills Required
- 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
- 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
Optum Compensation & Benefits Highlights
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Healthcare Strength — Health coverage offers copay and HSA medical options with dental, vision, company‑paid life and disability, and free or low‑cost virtual visits. Feedback suggests the offering is comprehensive and competitive on paper.
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Parental & Family Support — Time off and family supports include PTO, eight paid holidays plus a floating day, six weeks paid parental leave, up to two weeks paid caregiver leave, Bright Horizons back‑up care, and adoption assistance up to $10,000. Feedback suggests these resources are meaningful for caregivers and family needs.
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Retirement Support — Savings programs include a 401(k) with employer match (after one year, vesting after two) and a 10%‑discount Employee Stock Purchase Plan. These programs bolster long‑term financial security when combined with other savings resources.
Optum Insights
What We Do
Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.