Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 14 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
HEALTH CARE ANALYST SENIOR - QUALITY
Work Location: Work from Home or Office for your Day
As the Health Care Analyst Senior - Quality, you will be responsible for analytics and reporting of HEDIS, Medicare Stars, and quality of care measures. In addition, you will be responsible to independently lead projects of moderate scope and complexity, serving as the primary project liaison to other departments or external partners, performing ETL and QA on data sources used for reporting; creating monthly updates for HEDIS measure results; building internal quality measures, providing documentation, QA, and ad hoc analysis in support of the HEDIS Compliance Audit; and developing and maintaining SQL queries of high complexity or reports of significant importance that support the data needs of other UCare departments engaged in health quality improvement activities.
• Lead projects of moderate scope and complexity. Review and apply specifications and regulatory guidance. You will identify and prioritize project deliverables; design and execute project plans; communicate with internal and external stakeholders regarding issues, barriers, and ongoing status updates.
• Design, create, and maintain complex reports suitable for external audiences. Understand end user needs; determine the most suitable data and methodologies; create report data; and provide context and high-level analysis.
• Prepare data files for use by HEDIS vendor. Review and understand file layout specifications; perform data quality analysis on source files; use database software to transform data to layout; and identify and resolve issues with final files.
• Create monthly and quarterly measure results. Load source files; review data quality reports; review logs; troubleshoot performance issues; perform QA on results; identify, investigate, and resolve issues.
• Support the HEDIS/Stars/QRS data submission process and the HEDIS Compliance Audit. Assist with the investigation of data issues and perform ad hoc queries of higher complexity.
• Support data needs for initiatives designed to improve member health outcomes. Meet with business owners to define criteria and report layouts; Use SQL to write queries of higher complexity against UCare's Enterprise Data Warehouse; Ensure timely and accurate delivery of reporting and analysis to business owners.
• Develop and maintain expertise in the use of UCare's Business Intelligence tools, including Microsoft Excel, Microsoft SQL Server Management Studio, Azure Data Studio, Visual Studio Code, Business Objects, Python, Tableau, and other reporting software solutions.
• Develop and maintain subject matter expertise in HEDIS measure specifications, Medicare Star Ratings methodologies, Marketplace QRS reporting methodologies, and general methods of statistical data analysis.
• Serve as the primary project liaison to internal and external customers, including HEDIS Compliance Auditor, chart abstraction vendor, and staff from Quality Management, Clinical Services, Provider Relations, Information Services, and Health Promotions.
• Maintain a thorough understanding of the data structure within UCare's internal data systems, including membership, enrollment, claims, providers, and product lines.
• Represent the Health Care Economics department in internal committees and work groups, as assigned.
• Other projects and duties as assigned.
B.S./B.A. with an emphasis in Statistics, Computer Science, Mathematics, Public Health, or another field requiring extensive data analysis. Demonstrated experience in health care analytics, statistical analysis, SQL programming, or HEDIS reporting may be considered in lieu of a degree.
At least five years' experience with health care data analysis with at least two years' experience in database programming (preferably SQL), and HEDIS reporting.
Direct experience with administrative data and HEDIS reporting.
Additional experience with other major areas of healthcare analytics (risk adjustment, utilization, predictive modeling, etc.).
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 10/6/2023