Job Location: Fort Worth, TX
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
The Clinical Practice Performance Analyst is responsible for coordinating and implementing the STAR’s data collection and works in collaboration with the Director of Quality to develop strategies for achieving a 5 STAR rating. This role assists with data analysis and report preparation for all required data submissions. The Clinical Practice Performance Analyst provides direction and support to the various WellMed markets in the implementation of strategies for closing care gaps. This role works closely and collaboratively with various functional areas of the delivery system to achieve the goals and objectives of the Quality Improvement Program.
If you are located in Dallas/Fort Worth, TX, you will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
- Provides leadership and support in establishing the Quality Performance Initiatives at the market level.
- Collaborates with physicians to execute the implementation of the clinical quality initiatives as defined by enterprise
- Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data
- Work with IT on the interpretation of technical specifications and impact of HEDIS/STAR Measures to the data collection tools and reports utilized for the support of HEDIS/STAR measures
- Conduct training on HEDIS/STAR measures, HEDIS/STAR data collection software and data collection strategies
- Participate in NCQA HEDIS or Health Plan audits
- Work with external vendors on data transmission issues
- Analyze data for possible data integrity and data deficits
- Analyze and trend HEDIS/STAR rates, identify barriers to improvement of rates and creating interpretive exhibits
- Update QI Project templates and Work plan with assigned responsibilities
- Attend and participate in all QI meetings
- Performs all other related duties as assigned
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:
- HEDIS/STAR experience or participation with regulatory reporting
- 5+ years of healthcare experience to include experience in a managed care setting
- 3+ years of experience with data analysis
- Advanced Experience using Microsoft office applications, including but not limited to databases, word-processing, spreadsheets, and graphical displays
- Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
- Proven capability to work with people at all levels in an organization
Preferred Qualifications:
- BSN degree or related field
- CPHQ Certification
- CHCQM Certification
- Process management experience
- Healthcare Quality Improvement experience
- Excellent training and presentation skills with solid communication capabilities and practices, both oral and written
- Demonstrated effective organizational skills
- Excellent communication, writing, proofreading and grammar skills
- Solid attention to detail and accuracy, excellent Evaluative and Analytical skills
- Solid teamwork, interpersonal, verbal, written, and administrative and customer service skills
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmen t
Careers with WellMed. Our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors. We’re impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We’ve joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life’s best work.(sm)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Submit CV To All Data Science Job Consultants Across United States For Free