SDS Clinal Quality Analyst - HEDIS - Remote EST​/CST

Work Location

• Telecommute (home-based)
• Must have reliable, hardwired high-speed internet (Wi-Fi not permitted)

• Standard day shift: 9:00 AM - 5:00 PM (EST or CST)

• Small, highly collaborative team of 4 professionals
• Focus on quality, compliance, and audit readiness
• Team culture emphasizes:
  • Accountability and responsiveness
  • Strong attention to detail
  • Continuous feedback and improvement

If you are able to work EST/CST schedule, you will have the flexibility to work remotely as you take on some tough challenges.

• Section 5 Documentation Review & Optimization
  • Conduct comprehensive reviews of Section 5 submissions for completeness, accuracy, and compliance with NCQA standards
  • Provide actionable feedback and detailed editing recommendations to improve documentation quality
• Audit Readiness & Compliance Support
  • Ensure all supplemental data sources meet audit standards and are properly documented
  • Identify risks, gaps, or inconsistencies and recommend corrective actions
• Stakeholder Communication & Follow‑Up
  • Collaborate with internal teams to communicate required updates and track progress
  • Proactively follow up to confirm implementation of recommended changes
• Primary Source Verification (PSV)
  • Perform PSV activities, including chart reviews, for non‑standard supplemental data sources
  • Validate data integrity and ensure adherence to audit requirements
• Data Tracking & Tool Management
  • Accurately enter and maintain data within the SDS tracking tool
  • Track Section 5 progress, PSV results, and auditor issue logs
  • Ensure timely resolution and proper documentation of all audit findings
• Issue Identification & Resolution
  • Monitor and manage auditor feedback and issue logs
  • Support root cause analysis and corrective action tracking

• 2+ years of HEDIS audit experience
• Experience with Section 5 documentation
• Experience with Supplemental Data Sources (SDS)
• Able to work EST or CST schedule

• Experience supporting NCQA audits

• Exceptional attention to detail – ability to identify subtle discrepancies and ensure accuracy in documentation
• Strong written and verbal communication skills – clear, concise, and professional communication with stakeholders
• Responsiveness and accountability – ability to manage deadlines and follow through consistently
• Analytical thinking – ability to interpret audit requirements and apply them effectively
• Adaptability and quick learning – ability to rapidly understand tools, processes, and evolving audit requirements
• Technical Skills
  • Experience working with audit tracking tools or data systems
  • Proficiency in data entry, tracking, and documentation management
  • Familiarity with healthcare data, coding, and chart review processes preferred

* All employees working remotely will be required to adhere to United Health Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. The salary for this role will range from $60,200 - $107,400 annually based on full‑time employment. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution. All benefits are subject to eligibility requirements.

United Health Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.