Associate Director, QOI Data Operations (Remote)

UnitedHealthcare; Minnetonka (MN); Remote; USD 113,000 - 193,000; Full time

Benefits offered by this job

Remote work

Job summary

UnitedHealth Group is seeking an Associate Director of QOI Supplemental Data Operations to lead the evaluation, governance, and optimization of supplemental data sources for HEDIS, CMS, and audit programs. This remote-eligible role supports CST/EST time zones and partners across business and technology teams to deliver compliant, auditable data solutions.

The position manages a team, drives process improvements, and ensures data quality and audit readiness while aligning with NCQA guidelines and

Qualifications

• 3+ years of experience in Healthcare Industry with Quality/Process Improvement focus with understanding of medical terminology and clinical care
• 2+ years of experience with HEDIS documentation and auditing processes
• Experience working directly with HEDIS auditors and NCQA Roadmap documentation
• Experience leading teams and working across teams to achieve successful outcomes
• Experience defining and writing business requirements and working with technology
• Experience working with clinical data sources and types, including but not limited to: FHIR, CCD, HL7, ORU, ADT
• Understanding of data gathering/analysis
• Comprehensive understanding of HEDIS reporting with focus on supplemental data and audit requirements
• Advanced MS Excel and MS Access skills
• Advanced proficiency with MS Office (Including Word, Outlook, PowerPoint, Visio)
• Demonstrated success with project management and leading complex projects
• Demonstrated problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
• Demonstrated excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
• Proven ability to learn new technologies

Responsibilities

• Evaluate and manage supplemental data sources, including collaborating with other teams and resources across the enterprise who share responsibilities for specific SDS relationships
• Participate in activities and technologies which impact supplemental data including HIEs, Local Care Delivery and initiatives to increase receipt of EMR data
• Work with internal and external partners to better define supplemental data source requirements for development and implementation
• Stay current with new technology / data sources being developed within UnitedHealth Group
• Identify source opportunities and lead team collaboration to develop action plans to implement solutions into existing production
• Work on new source implementation review and validations of onboarding activities
• Recommend corrective action plans (CAP) for sources in alignment with NCQA, CMS, and auditors
• Consult on HEDIS source strategy and risk mitigation plans
• Oversee and manage year-round internal efforts to complete internal source validations and audits
• Support data completeness strategies and validations and identify required updates
• Work directly with HEDIS auditors, build and maintain excellent relationships with all auditor contacts
• Act as the primary supplemental data audit liaison for the enterprise
• Ensure all stakeholders are informed and engaged, especially key line of business and technology leaders
• Support and consultation on supplemental data audit requirements, including roadmap requirements, source responses to auditor questions, interpretation of NCQA technical specifications and future changes
• Participate in Executive level meetings and prepare presentations
• Serve as a leader/ mentor and sought out as an expert
• Maintain and execute communication plans
• Assesses and interprets customer needs and requirements
• Translate requirements into technical specifications
• Develop & produce ad-hoc reports
• Solves complex problems and/or conducts complex analyses
• Work independently; seeks guidance on only the most complex tasks
• Manage team of analysts

Skills

Leadership

Project management

Quality improvement

Communication

Healthcare industry knowledge

Data analysis

Education

Bachelor's degree or higher in a related field

Tools

SQL

FHIR

HL7

CCD

ORU

ADT

Job description

UnitedHealth Group is seeking an Associate Director of QOI Supplemental Data Operations to lead the evaluation, governance, and optimization of supplemental data sources for HEDIS, CMS, and audit programs. This remote-eligible role supports CST/EST time zones and partners across business and technology teams to deliver compliant, auditable data solutions.

The position manages a team, drives process improvements, and ensures data quality and audit readiness while aligning with NCQA guidelines and