Senior Business Process Analyst - Remote

At United Healthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
Our Quality Reporting Operations team is vital to our success and driving the future growth of United Health Group. Success in these careers relies on many factors - your ability to deal with ambiguity, your ability to adapt and embrace change, and a long-term commitment to making health care better for everyone.
You'll enjoy the flexibility to work telecommute
* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

• Facilitate, oversee and monitor on-going business processes to support HEDIS® data reporting
  • Monitor compliance against relevant process requirements (e.g., turnaround time, accuracy)
  • Evaluate processes and outcomes against benchmarks and metrics and identify potential business impacts of current state
  • Ensure all business requirements are met
• Demonstrate understanding of relevant organizations' operations, products and applications, strategies, processes, and/or business priorities to build effective solutions including development of project plans (e.g., communication plans; implementation steps) to support operations using relevant tools and databases
  • Submission of the NCQA Health plan Roadmap General Information, Appendix and Attestation
  • Submission of the NCQA Healthcare Organization Questionnaire (HOQ)
  • Complete admin and hybrid measure benchmarking and rate review to resolve all CHCA (Auditor) rate outlier concerns throughout the HEDIS® project (Initial, Refresh, Final) on complex projects
  • Perform SDS, administrative refresh data loads and vendor medical record event data loads to the hybrid project and update rates
  • Perform all MRR project build steps, including QA, to ensure each hybrid MRR project is set up according to business requirements
  • Coordinate with medical record vendors on file loads and resolving technical project issues
  • Confirmation of all hybrid exclusions entered into HEDIS® software, coordinating clinical review when necessary
  • Complete all HEDIS® software upgrade steps as required
  • Create and validate all final hybrid frozen counts and deliver to CHCA
  • Complete all final hybrid project close steps, including validation of all exclusions and QA of all final data and rates
  • Complete all final admin and hybrid project processing
  • Creation of IDSS exports and submission to NCQA
  • Creation of PLD exports and submission to CHCA and/or CMS
  • Submission of State required reporting if applicable
  • Coordinate efforts with the LOB Operations team to ensure all business requirements and deliverables are met
  • May also assist in supporting chase status updates, chase activations, query exports and special request data analysis or validation
• Monitor and analyze business process information (e.g., metrics; analytics) to identify key issues, trends, and potential root causes (e.g., training issues; lack of understanding by user community) that point to improvement opportunities
  • Participate in analysis of project outcomes to generate data driven recommendations for process improvement
  • Lead and participate in work groups to implement process improvement and/or in preparation to meet business requirements
  • Participate in HEDIS® software system testing efforts to ensure project preparedness
  • Use a process driven approach to identify root cause and…