For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) If you are located in Iowa, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:Analyzes processes and makes recommendations for improvement Monitors plan reporting to ensure compliance with contractual requirements and performance targets Interfaces with internal teams to measure performance, document improvements and opportunities and develop remediation plans with plan leadership Business requirement development and documentation Health plan clinical department support, including care coordination and LTSS program operations Provides support for health plan projects and programs, including implementations, new programs and innovative solutions to address customer needs Provides operational and analytical support for larger scale projects and programs Maintains sources of truth for health plan operations, vendor and other reporting Supports both internal and external audits, including regulatory audits
Required Qualifications:Bachelor's Degree Programming knowledge (reporting code) and of relational databases, database structures and design, systems design, data management, data warehouse - this includes SQL and Crystal Reports Proficient with Microsoft Excel (i.e. queries and macros) 1+ year experience with Managed Care and / or with health plans Preferred Qualifications:Ability to develop SQL reports Prior experience working with a leadership team Experience with SharePoint administration and maintenance Project Management experience Experience with specialized populations such as Medicare, Medicaid, and Long Term Care Experience with regulatory auditsCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Quality, HEDIS, Quality Analyst, Social Worker, Nurse, RN, Registered Nurse, Medicaid, Medicare, Waiver, Iowa, IA, Des Moines, Bachelor's, LTSS, SQL, macros, Excel, Crystal, health plan, telecommute, project manager
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.