Job: Clinical Quality Analyst (Telecommute from anywhere in the US!)

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Jobing Description

UnitedHealthcare's Quality Management & Performance is an integrated team serving all UnitedHealthcare businesses, focused on improving the health of our members, enhancing our operational effectiveness, reinforcing our brand and reputation for high-quality health plans and helping members lives healthier lives. We are seeking a Clinical Quality Analyst to perform detailed analysis and reporting for our Community and State business unit.


In addition to working with the Quality Management & Performance HEDIS staff, this position will collaborate and work closely with other key areas of quality including National and Regional Accreditation teams, CAHPS teams, CMS/SNP teams and others. This individual will also work with external partners to ensure optimal HEDIS performance, including data collection related to vendors and auditors.


Daily duties will include the following.

Responsible for a variety of functions in areas such as health care data analytics, Quality Improvement measurement and analysis

Identifies solutions to non-standard requests and problems.

Solves moderately complex problems and/or conducts moderately complex analysis.

Conducts measurements and analysis associated with NCQA , State and CMS requirements.

Completes reporting and analysis of member care quality and for the development of plans and programs to support continuous quality improvement using HEDIS and other tools.

Supports HEDIS and QIP data analysis and trending required for accreditation, quality improvement activity, reporting and analysis.

Responsible for direction and guidance on clinical quality improvement and management programs including accreditation.

Reporting and analysis of member care quality and for the development of plans and programs to support continuous quality improvement using HEDIS and other tools.

Provides explanations and interpretations within area of expertise.

Conducts clinical quality audits and may also be responsible for NCQA requirements.

Responsible for the reporting and analysis of member care quality and for the development of plans and programs to support continuous quality improvement using HEDIS and other tools.

Skills / Requirements

In order to be considered, qualified applicants must possess the following.



A minimum of 3 years managed care or health care experience, including knowledge of clinical quality measures / HEDIS



Demonstrated proficiency in Microsoft Office applications, including the ability to develop, build and run Access databases and queries, as well as advanced Excel skills; experience using SQL is a plus

Experience translating Clinical Quality Reporting Requirements to IT Technical Specifications a plus.



Quality Management & Performance combines talented individuals from many areas of quality, including HEDIS, CAHPS and Accreditation. Our goal is extraordinary performance that exceeds the expectations of the constituents, customers and members we serve. UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being. Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.



Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.