Network Integrity & Quality Team Quality Analyst

Network Integrity & Quality Team Provider Data Analyst

This position is National Remote. You'll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Network Integrity & Quality Team Provider Data Analyst supports the Quality Management and Quality Improvement operational area within the Network Integrity and Performance quality management system. This position is responsible for coordinating, analyzing, validating, and administering provider data quality activities that support operational oversight, quality governance, contractual compliance, and continuous process improvement. The role provides essential operational infrastructure for recurring daily, weekly, monthly, quarterly, and annual quality activities and supports execution of VA CCN quality program requirements, including the Quality Assurance Plan and Quality Assurance Surveillance Plan.

The statements listed below are not intended to be all inclusive of the duties and responsibilities of the position. Based on leadership decisions and business needs, 'all other duties as assigned' will be expected for each position. Create reports, analyze data and identify trends.

This position is full-time. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm.

We offer weeks of paid training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

Primary Responsibilities:

• Manage workload assignment, tracking, and coordination for quality team activities, including audit sampling, census management, follow-up actions, and recurring operational deliverables.
• Develop audit sampling populations, administer Audit-the-Auditor activities, support SOC audit processes, and compile audit trend analysis to support quality oversight and audit readiness.
• Maintain and monitor operational quality metrics, operational controls, quality controls, error trends, performance thresholds, and corrective action follow-up activities.
• Build, maintain, and administer Smartsheet workflows, dashboards, scorecards, workflow automation, and quality work management tools that support operational visibility and governance reporting.
• Validate provider and quality data to support reporting accuracy, data integrity, executive decision-making, and contractual quality reporting requirements.
• Support quality governance reporting and operational reviews through statistical process control, control charts, Pareto analysis, performance reporting, and ad hoc operational data analysis.
• Develop and maintain audit workflows that support provider data, provider directory quality reporting, contractual quality deliverables, and continuous process improvement initiatives.
• Uses pertinent data and facts to identify and solve a range of problems within area of expertise
• Works exclusively within a specific knowledge area to include quality and provider data
• Lead and or participate in applicable projects;
  Prioritizes and organizes own work to meet deadlines
• Provides problem identification, root cause, explanations, solution and information to others on topics within area of expertise
• Training on new and existing processes as needed
• All other duties as assigned

Primary Skills and Functional Competencies

• Strong analytical, critical thinking, and problem-solving skills with the ability to evaluate operational data, identify trends, and support quality improvement decisions.
• Experience with quality management systems, audit administration, data validation, workflow management, and governance reporting.
• Ability to develop and maintain dashboards, scorecards, work management tools, and reporting mechanisms that support operational oversight and leadership visibility.
• Knowledge of audit sampling, trend analysis, quality controls, corrective action monitoring, and continuous process improvement methods.
• Experience supporting quality, operational oversight, provider data, network operations, credentialing, compliance, or related operational functions with demonstrated understanding of basic quality programs
• Strong attention to detail, organizational skills, and ability to manage recurring deliverables across multiple operational…