The
Quality Clinical Analyst supports quality improvement initiatives with a focus on maternal/child health and behavioral health, value-based programs (VBP), provider engagement, reporting, and quality assurance initiatives. This role analyzes clinical and operational data, maintains Key Performance Indicator (KPI) dashboards, prepares presentations, manages and supports "Alternate Payments Contracts/ Models- Learning and Action Network/Value Based Program" (APC-LAN/VBP) deliverables, and coordinates program communications to improve outcomes, provider performance, HEDIS® compliance, and Nevada market quality and state goals.
If you are located in
Las Vegas, NV, you will have the flexibility to work remotely* as you take on some tough challenges.
Key Responsibilities- Manage and support quality improvement, population health, value-based program, provider communication, quality assurance, state-required programs, and APC-LAN initiatives
- Coordinate APC-LAN activities for assigned facilities, behavioral health providers, and OB-GYN practices, including benchmark reporting, provider performance tracking, and quarterly Joint Operating Committee (JOC) support
- Support High-Risk Maternal Case Management, Value-Added Services, value-based program reporting, provider communications, and quality assurance requirements
- Facilitate quality improvement program workstreams, including value-added benefit reporting, intervention tracking, workgroups, committees, and performance improvement initiatives
Report Analysis and Monitoring- Analyze clinical, operational, productivity, and maternal health reports to identify trends, gaps, opportunities, and workflow improvement needs
- Monitor population health interventions, program goals, and Medicaid maternal and child health contractual requirements
- Develop and maintain KPI dashboards to support leadership review, performance monitoring, and data-informed decision-making
- Apply report findings to support compliance, regulatory standards, and quality improvement action planning
Presentation and Meeting Support- Develop and maintain presentation materials for maternal health, OB, provider, quality improvement, committee, leadership, state-contracted, and stakeholder meetings
- Summarize data, trends, barriers, risks, interventions, and outcomes in a clear, concise, and professional format
- Prepare presentation decks that support performance review, opportunity identification, and improvement strategy discussions
Communication and Resource Management- Monitor internal and external communications, including email and call lines, to ensure timely routing, follow-up, and documentation of inquiries
- Support the development of program, presentation, and project materials for internal and external stakeholders, provider and member audiences, and state-contracted communications
- Ensure all communication materials are high level, accurate, professional, timely, and aligned with program priorities
Systems and Tools- Create and maintain Word documents, PowerPoint presentations, Excel trackers, project timelines, action item logs, report summaries, dashboards, meeting materials, and audit-ready records
- Use Excel formulas, filters, pivot tables, conditional formatting, data validation, and reporting logic to support analysis, tracking, dashboard updates, and process improvement
- Use AI tools to assess work products and workflows for automation, augmentation, and enhancement opportunities
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 Data analysis, reporting, and performance monitoring
- 2+ years of Project organization, documentation management, and process improvement support
- 2+ years of experience project coordination, organization, deadline management, communication, and collaboration skills
- Advanced proficiency with Microsoft Excel, Power Query, formulas, filters, pivot tables, and data tracking tools
- Advanced proficiency Adobe Acrobat and Microsoft Office applications to support documentation, reporting, and presentation development
- Advanced Proficiency with Power Point - Ability to develop polished, professional presentations for leadership, committees, state, and stakeholder audiences
Preferred Qualifications:- Experience in healthcare quality, Medicaid, managed care, population health, maternal health, behavioral health, or provider engagement
- Knowledge of case management systems, electronic medical record navigation, claims systems, HEDIS® chart review, and secure file transfer protocols within a healthcare environment
- Experience using Power BI and Adobe Workfront/MOTE preferred
- Strong attention to data accuracy, clear communication, and cross-functional collaboration
*All Telecommuters 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 hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
