Healthcare Quality Measurement Consultant, Data Analytics and Coding - Remote

Colorado Psychiatric; Reston, Northern (VA, KY); Hybrid; USD 92,000 - 164,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Job summary

Optum Serve Consulting/The Lewin Group (OSC/Lewin) is seeking a Healthcare Data Analytics Consultant, Quality Measurement to lead data-driven quality initiatives across CMS programs. You will transform policy requirements into technical specifications, design automated measure calculations, and guide client engagements with strategic insights.

The role offers remote work nationwide with occasional collaboration across US teams.

Qualifications

• 4+ years health policy experience in health services research, evaluation or policy
• Experience leading business development and proposal responses
• Experience with quality measure engagements, federal programs, CMS familiarity
• Experience with data sources for health care quality (claims, EHR, chart data)
• Ability to translate policy and measure specs into technical requirements

Responsibilities

• Evaluate evidence on effectiveness for clinical measures from multiple data sources in CMS, AHRQ, NQF requirements
• Perform hands-on coding to extract, transform, analyze, and validate large healthcare datasets using Python, SQL, R, or SAS
• Design and implement coding solutions that automate measure calculations and quality reporting
• Develop test measure protocols and measure specifications
• Conduct quantitative analyses to inform Medicare/Medicaid payment models
• Track activities of standards-setting committees and NQF
• Draft and manage proposals for new projects on measure development and implementation
• Engage, develop, cultivate and expand client relationships through policy consulting and thought leadership
• Support development of long-term growth strategy with organizational leadership
• Manage project delivery teams and mentor junior members

Skills

Health policy expertise

Business development experience

Quality measurement experience

Healthcare data analysis

Cross-functional collaboration

EHR/Claims data experience

Education

Advanced degree in medicine, economics, health policy, or related field

Bachelor's degree with 6+ years experience

Tools

Python

SQL

R

SAS

Job description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors.

In the wide-ranging field of health human services consulting, OSC/Lewin provides both depth and breadth of expertise. Currently, OSC/Lewin has more than 250 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin's core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction.

At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. We are seeking a passionate, visionary, and growth-oriented leader who can deliver innovative solutions to our clients. The successful candidate for Healthcare Data Analytics Consultant, Quality Measurement will be an established and recognized thought leader with a solid track record in supporting quality measurement contracts and business development.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Evaluate evidence on effectiveness for clinical measures derived from administrative or claims data, health records, electronic health records, other data sources in compliance with Centers for Medicare & Medicaid Services (CMS), the Agency for Healthcare Research and Quality, and the National Quality Forum (NQF) requirements
• Perform hands-on coding to extract, transform, analyze, and validate large healthcare datasets using programming languages such as Python, SQL, R, or SAS." AND " Design and implement coding solutions that automate measure calculations, quality reporting processes, and value-based care performance analyses
• Develop test measure protocols and measure specifications
• Perform a broad range of quantitative analysis to inform quality measurement for Medicare and Medicaid payment models
• Track activities of key standards-setting committees and consensus-based organizations such as NQF
• Draft and manage proposals for new projects related to measure development, testing, maintenance, and implementation
• Engage, develop, cultivate and expand new and existing client relationships through policy consultation and thought leadership
• Support the continued development of existing strategy to fuel long-term organizational growth in partnership with organizational leadership
• Manage project delivery teams responsible for day-to-day project execution
• Mentor other team members to develop their technical and analytical problem-solving skills

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:

• Health policy professional with 4+ years of industry experience in health services research, evaluation and/or policy including solid analytic skills and advanced degree (M.D., D.O., Master's degree, or Ph.D.) in medicine, economics, health policy research, or similar discipline OR a Bachelor's degree with 6+ years of experience
• Experience in leading business development and proposal response efforts, including engaging with clients and partners in the business development process
• Experience working on quality measure engagements, preferably for federal programs, including those at CMS
• Experience working with various types of data used to measure health care quality (e.g., administrative claims, instrument-collected data, chart-abstracted data, EHR output)
• Experience collaborating with and building consensus with diverse teams ability to communicate with individuals of varying technical aptitudes and professional backgrounds
• Experience working with clinical data from EHRs and/or claims data in a quality measurement context
• Demonstrated experience implementing or supporting eCQMs for CMS programs (e.g., IQR, MIPS, ACOs, Innovation Center models)
• Broad understanding of federal or state health policy issues, with ability to work in multiple areas serving as a subject matter expert
• Solid understanding of CMS quality measure specifications, including numerators, denominators, exclusions, and data completeness rules
• Proven ability to translate policy and measure specifications into technical requirements and implementation logic

Preferred Qualifications:

• Experience supporting multi-year quality measure development or implementation contracts
• Experience with databases having complex structures and relationships, such as the Integrated Data Repository, Chronic Conditions Warehouse, or similar data environment

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline:

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.