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Job Details

Government Programs Quality Analyst

Company name
UnitedHealth Group

Schaumburg, IL

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We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm)

The Government Programs Quality Analyst will be accountable for contributing to the development and oversight of OptumRxs Quality Measure Analytic Programs. In this role, the Government Programs Quality Analyst will utilize knowledge of CMS' regulations and quality measure requirements to promote the improvement of pharmacy quality and plan ratings. This position contributes to efforts to implement and develop Stars-related offerings as an analytics expert. The Government Programs Quality Analyst will provide and execute upon internal and external strategies and initiatives to improve the Star analytics offering.

The individual in this role will be knowledgeable in the quality measure needs and concerns of Part D plan sponsors. To perform this job successfully, an individual must be able to navigate through various IT systems and applications to create and execute on new analytic offerings.

Preferred Location for this role is within the Schaumburg, IL office.

Primary Responsibilities:

Monitor guidance from CMS, Acumen, PQA, etc. and participate in work groups, meetings, and conferences related to pharmacy quality measures and outcomes

Build consensus around strategic direction of clinical reporting related to quality measures and lead development of new and existing reporting related to quality and outcomes for Medicare beneficiaries and related programs

Coordinate shared knowledge and effectively communicate guidance changes with cross functional teams within the organization including clinical, operational and account teams

Share outcomes results and provide training related to department analytic products

Consult with internal partners to drive process development, management, and continuous improvement efforts in support of Stars programs

Provide support to implementation of new quality measure analytic offerings

Identify and execute on process efficiencies, automation and improvement strategies

Monitor new measures and changes in measure requirements to assist with delivering CMS compliant services related to these requirements


Required Qualifications:

Bachelor's degree in computer, data analytics or related field; 2 years of equivalent work experience

Strong technical background and knowledge of drug data

Excellent analytical, problem-solving, and interpersonal skills

Excellent verbal and written communications skills

Preferred Qualifications:

SAS, SQL, VB (Visual Basic) programming language and advanced Office experience

2 years of Medicare, managed care, PBM or health plan experience

Working knowledge of database structures and claims data experience

Previous experience in Medicare, managed care, PBM or health plan experience

Experience in Med D clinical program support and quality measures is a plus

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here youll fill far more than prescriptions. As a member of one of our pharmacy teams, youre empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

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: Government Programs Quality Analyst, Government Programs, Quality Analyst, CMS regulations, quality measure requirements, Stars, CMS, Acumen, PQA, PBM, Health Plan Pharmacy and Telecommute,

Company info

UnitedHealth Group
Website :

Company Profile
About UnitedHealth Group UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone. We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term

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