UnitedHealth Group

Healthcare Quality Measurement Consultant, Data Analytics and Coding - Remote

UnitedHealth Group$91K — $163K *
US-AnywhereRemote in Reston, VA
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 4+ years in health services research or related field, with analytical skills and advanced degree (M.D., D.O., Master's, or Ph.D.) or 6+ years with a Bachelor's degree.
  • Proven experience in business development and proposal writing, engaging with clients and partners.
  • Experience with quality measure engagements, preferably within federal programs like CMS.
  • Familiarity with various data types used for healthcare quality measurement, including administrative claims and EHRs.
  • Skill in collaborating with diverse teams and communicating across varying levels of technical expertise.
  • Experience implementing or supporting electronic clinical quality measures (eCQMs) for CMS programs.
  • Broad understanding of federal and state health policy issues, maintaining subject matter expertise.

Responsibilities

  • Evaluate clinical measure effectiveness using various data sources per CMS and quality forum guidelines.
  • Extract, transform, analyze, and validate large health datasets using Python, SQL, R, or SAS; automate quality report processes.
  • Develop protocols and specifications for testing healthcare measures.
  • Conduct quantitative analyses to inform Medicare and Medicaid payment models.
  • Monitor standards-setting committees and consensus organizations.
  • Draft and manage project proposals for measure development and implementation.
  • Cultivate and expand client relationships through consultation and leadership engagement.
  • Oversee project delivery teams and mentor junior staff in analytical skills.

Benefits

  • Flexibility to work remotely from anywhere in the U.S. (office requirement for local hires in Minneapolis or D.C.).
  • Comprehensive benefits package including health, wellness, and professional development programs.
  • Incentive and recognition programs to reward performance.
  • Equity stock purchase options and 401k contributions.
  • Support for ongoing career development and advancement opportunities.
Full Job Description


Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors.

In the wide-ranging field of health human services consulting, OSC/Lewin provides both depth and breadth of expertise. Currently, OSC/Lewin has more than 250 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin's core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction.

At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. We are seeking a passionate, visionary, and growth-oriented leader who can deliver innovate solutions to our clients. The successful candidate for Healthcare Data Analytics Consultant, Quality Measurement will be an established and recognized thought leader with a solid track record in supporting quality measurement contracts and business development.

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:

  • Evaluate evidence on effectiveness for clinical measures derived from administrative or claims data, health records, electronic health records, other data sources in compliance with Centers for Medicare & Medicaid Services (CMS), the Agency for Healthcare Research and Quality, and the National Quality Forum (NQF) requirements
  • Perform hands-on coding to extract, transform, analyze, and validate large healthcare datasets using programming languages such as Python, SQL, R, or SAS." AND " Design and implement coding solutions that automate measure calculations, quality reporting processes, and value-based care performance analyses
  • Develop test measure protocols and measure specifications
  • Perform a broad range of quantitative analysis to inform quality measurement for Medicare and Medicaid payment models
  • Track activities of key standards-setting committees and consensus-based organizations such as NQF
  • Draft and manage proposals for new projects related to measure development, testing, maintenance, and implementation
  • Engage, develop, cultivate and expand new and existing client relationships through policy consultation and thought leadership
  • Support the continued development of existing strategy to fuel long-term organizational growth in partnership with organizational leadership
  • Manage project delivery teams responsible for day-to-day project execution
  • Mentor other team members to develop their technical and analytical problem-solving skills


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:

  • Health policy professional with 4+ years of industry experience in health services research, evaluation and/or policy including solid analytic skills and advanced degree (M.D., D.O., Master's degree, or Ph.D.) in medicine, economics, health policy research, or similar discipline OR a Bachelor's degree with 6+ years of experience
  • Experience in leading business development and proposal response efforts, including engaging with clients and partners in the business development process
  • Experience working on quality measure engagements, preferably for federal programs, including those at CMS
  • Experience working with various types of data used to measure health care quality (e.g., administrative claims, instrument-collected data, chart-abstracted data, EHR output)
  • Experience collaborating with and building consensus with diverse teams ability to communicate with individuals of varying technical aptitudes and professional backgrounds
  • Experience working with clinical data from EHRs and/or claims data in a quality measurement context
  • Demonstrated experience implementing or supporting eCQMs for CMS programs (e.g., IQR, MIPS, ACOs, Innovation Center models)
  • Broad understanding of federal or state health policy issues, with ability to work in multiple areas serving as a subject matter expert
  • Solid understanding of CMS quality measure specifications, including numerators, denominators, exclusions, and data completeness rules
  • Proven ability to translate policy and measure specifications into technical requirements and implementation logic


Preferred Qualifications:

  • Experience supporting multi-year quality measure development or implementation contracts
  • Experience with databases having complex structures and relationships, such as the Integrated Data Repository, Chronic Conditions Warehouse, or similar data environment


*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 $91,700 - $163,700 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.

About UnitedHealth Group

UnitedHealth Group is a medical facility. They offer health technology, health finance, and pharmacy services. They are utilizing clinical data and intelligence to assist in the redesign, automation, and deployment of technology to streamline administrative operations and clinical decision-making. Payment systems for both consumers and providers are critical components of a health-care system.

UnitedHealth Group Careers

Joining UnitedHealth Group means becoming part of a diverse team dedicated to making a difference. As a leader in health services and innovation, our company offers a variety of job opportunities that allow professionals to leverage their skills, drive innovation, and improve lives. Work You’ll Do At UnitedHealth Group, you’ll contribute to a mission-focused environment where your expertise will influence the health and well-being of people worldwide. Our employment opportunities span across a wide range of disciplines, from healthcare specialists to data analysts, ensuring that your career journey is both dynamic and rewarding. Transform Healthcare with Your Expertise UnitedHealth Group stands at the forefront of health innovation. Our team collaborates to deliver solutions that lead to better patient outcomes. Working with us, you’ll find yourself at the intersection of technology, healthcare, and leadership, providing key insights that drive industry transformation. Join Our Global Team As part of our team, you’ll engage with over 300,000 professionals globally, dedicated to building a diverse and inclusive workplace. UnitedHealth Group is not just a company; it’s a community where you can grow your career through continuous learning and leadership opportunities. Our commitment to diversity training ensures that every team member can thrive. UnitedHealth Group Career Development We are committed to your professional growth. Explore career paths filled with promising job opportunities and internships that will harness your potential and expand your capabilities. Whether you’re a seasoned professional or a recent graduate, you’ll find that our career development programs support your ambition at every level. Innovative Work Environment At UnitedHealth Group, innovation is at the core of our operations. We encourage our team to bring forward-thinking ideas that challenge the status quo and lead to breakthrough improvements in patient care. Be Part of a Great Team Our culture fosters a collaborative and supportive environment where every member’s contribution is valued. Enjoy the benefits of being part of a global team that’s committed to making a difference in people’s lives. Future-Proof Your Career With UnitedHealth Group, your career is future-proof. Dive into a range of positions that offer both challenges and rewards. Our robust support system includes unmatched training, development programs, and certification support to propel your career forward. Stay Connected Join Our Team Discover the right position that matches your skills and interests. We are always hiring and look for passionate, curious, and solution-driven team players. Search UnitedHealth Group jobs today and take the first step towards a fulfilling career. Keep Up to Date Stay informed with career tips, insider perspectives, and industry-leading insights you can use today—all from the people who work here. Read Careers Blog Job Alert Emails Customize your subscription to receive job alerts, the latest news, and insider tips tailored to your preferences. Explore the exciting and rewarding opportunities that await at UnitedHealth Group.
Learn more about UnitedHealth Group
Size
350,000 employees
Market Cap
$493.1 billion
Industry
Net Income
$15.4 billion
Founded
1974
5 Year Trend
+9.2%
Revenue
$257.1 billion
NASDAQ

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