Manager, Quality Data Support DescriptionIf you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) Position SummaryWe are seeking a Manager, Quality Data Support for our San Antonio, TX location to manage the in-depth interpretation, reporting, analysis and regulatory submission of Wellmed's clinical quality data as necessary to ensure the highest possible annual HEDIS/Star rating. Specific duties include the following: lead a team of developers and analysts to support and collaborate with Wellmed business sponsors and Insurance Payer representatives; identify risks and areas for improvement in both data and processes, and communicates to all levels of leadership to ensure minimal risk to HEDIS/Star ratings; responsible for team activities involving all database design, technical requirements and documentation, testing, data extraction and distribution to health plan partners; devise data verification and quality methods and standard system procedures that are used to support enterprise data warehouse and business intelligence platforms; develop complex programs in T-SQL, write Stored Procedures, Cursors and Queries with best execution plan to retrieve data from the database for HEDIS Submission; create sETL Technical documents for Process Flows, Business Rules, and Execution Dependencies; use SQL Server Import/Export Wizard and SSIS for performing the ETL operations. Gather business requirements and create Facts and Dimension for data mart; solve unique and complex problems with broad impact on the business; develop the audit process to evaluate the source systems for data integrity and availability; work with production services team to promote the ETL objects across the different environments and create the workflow job plans; manage HEDIS/Star technical team on completion of initial audit documents, issues of sampling methodology, data collection strategies, and HEDIS measure interpretation; analyze and trend HEDIS rates, identifies barriers to improve rates and collaborates with cross-functional teams to resolve barriers; provide leadership, analysis and technical guidance for implementation of HEDIS/Star tools; provide ongoing support and measure interpretations of NCQA HEDIS Technical Specification, CMS Star Technical Specification and MACRA or related quality specifications for multiple departments within WellMed; and stay current on all CMS, MACRA, NCQA, HEDIS/Star, and related communications to align WellMed data submissions strategies to minimize risk to data submissions, audits, and overall scores. Will supervise 10-18 subordinate Data Warehouse Developers, Business Systems Analyst, and Report Developers.
QualificationsMust have a Master's degree or equivalent in Industrial Engineering, Computer Science or related field and 3 years of related experience; or in the alternate, a Bachelor's degree or equivalent in Industrial Engineering, Computer Science or related field and 5 years related, progressive, post-baccalaureate experience. Will accept experience gained concurrently. Will accept experience gained before, during or after Master's program. Must also have demonstrated ability with each of the following: 1) Data release governance with applications to HIPAA/HITECH regulatory requirements; 2) Ability to read and understand NCQA HEDIS technical specifications and interpret these specifications into functional and verifiable SQL code; 3) Informatics and ETL experience, SQL Server experience (Version 2005 or higher), Visual Studio (Version 2005 or higher), SQL SSIS experience, and SQL & Querying Tuning; 4) Advising and developing appropriate reporting tables, OLAP Cubes, Data marts or Data stores as situations dictate; and 5) Centers for Medicare & Medicaid (CMS) Star quality program data submission. Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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.
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.