Quality Process Improvement 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities.

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

The Quality Process Improvement (QPI) Analyst supports Optum Rx PBM quality issues through execution of root cause analysis (RCA), trend analysis, and quality reporting activities to help identify, document, and monitor quality issues and Cost of Poor Quality (CoPQ) drivers. This role gathers and organizes data, documents findings using established QPI frameworks, and assists with evaluating client remediation activity, performance guarantee impacts, and recurring process gaps.

The QPI Analyst contributes accurate, structured analysis that supports corrective and preventive action tracking, process consistency, and improved visibility into quality and business outcomes.

This position is full time (40 hours / week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime.

This is on-the-job training. The hours of training will be based on your schedule or will be discussed on your first day of employment.

Primary Responsibilities:

* RCA Ownership:
Contribute to root cause analysis activities by gathering data, reviewing evidence, documenting contributing factors, and supporting issue clarification using established QPI frameworks.

* Financial & CoPQ Acumen:
Understand and apply core quality, financial, CoPQ, remediation, and performance guarantee metrics to support analysis, reporting, and trend visibility.

* Executive Storytelling:
Report data accurately by preparing structured summaries, dashboards, reporting inputs, and leadership update materials that communicate quality trends, risks, impacts, and next steps.

* Preventive Solutioning:
Support fixes by assisting with identification, documentation, tracking, and monitoring of corrective and preventive action opportunities designed to reduce recurrence and improve quality outcomes.

* Control Design:
Execute established controls by following defined monitoring steps, documenting results, and supporting validation that actions are implemented and operating as intended.

* Stakeholder Influence:
Work within the QPI team and with guided internal partners to gather information, clarify documentation needs, communicate findings, and support issue resolution.

* Standardization / Scaling:
Follow defined QPI standards, templates, taxonomies, documentation practices, and reporting routines to promote consistency, repeatability, and process discipline.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

* High School Diploma / GED

* Must be 18 years of age OR older

* 3+ years of experience in operations, quality, analytics, reporting, process improvement, or root cause analysis support.

* Experience supporting structured problem-solving, issue documentation, or root cause analysis activities using defined processes or templates.

* Data analysis and trend identification

* Documentation of findings, evidence, corrective actions, and preventive actions

* Internal stakeholder communication, information gathering, and follow-up

* Proficiency with Microsoft Excel

* Foundational RCA concepts, contributing factor analysis, corrective/preventive actions, and effectiveness monitoring

* Reporting concepts, trend analysis, issue categorization, and stakeholder insights

* Ability to work full time (40 hours / week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

* 3+ years of PBM operations, Optum Rx operations, or healthcare quality experience.

* Experience with CoPQ, client remediation, performance guarantees, quality defect analysis, or operational issue analysis.

* Experience supporting process mapping, workflow…