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UnitedHealth Group

Associate Director - QOI Supplemental Data Operations - Remote CST or EST

Posted 14 days ago
$112K - $193K per year
5-10 years experience
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AI Summary

The Associate Director leads the evaluation, governance, and optimization of clinical supplemental data sources to ensure compliance with HEDIS and regulatory requirements. This role manages a team to drive process improvements, audit readiness, and strategic data integrations across the enterprise.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.


The Associate Director, Supplemental Data Operations, is responsible for providing leadership and consultation for the evaluation, governance, and optimization of clinical supplemental data sources that support Commercial, Medicare, and Medicaid reporting for HEDIS®, CMS, state regulatory requirements, and quality programs. This role is accountable for ensuring supplemental data sources are assessed, implemented, and maintained in alignment with NCQA guidelines, HEDIS technical specifications, and audit requirements, while maximizing enterprise value and data quality outcomes. The leader partners across the enterprise with business, clinical, operational, technology, and reporting stakeholders to evaluate new and existing sources, vendor solutions, data integrations, and strategic initiatives. Through collaboration with stakeholders, this role is focused on ensuring supplemental data sources and processes are fit-for-purpose, auditable, and meet HEDIS reporting standards starting at implementation and continuing throughout the life cycle of the sources. The Associate Director serves as a trusted advisor to support business decision-making, identify risks and opportunities, and guide the development of compliant, scalable solutions that achieve intended quality objectives.


This position supports overseeing supplemental data source governance, including efficacy evaluations, audit readiness activities, auditor approvals, documentation standards, and business requirements development. The role will manage a team responsible for driving continuous process improvement through proactive identification of data quality opportunities, compliance, and operational efficiencies, establishing action plans that strengthen accuracy, efficiency and reduce audit risk.


Additionally, the Associate Director maintains executive-level communications and stakeholder engagement strategies, regularly participating in enterprise governance forums and quality leadership meetings to ensure alignment, transparency, and informed decision-making across the organization. Success in this role is measured by the ability to influence cross-functional teams, drive technical and operational solutions that support data quality, ensure audit-ready supplemental data, and enable strategic business initiatives that deliver reliable, compliant, and measurable quality outcomes.


If you are able to work Central or Eastern Time Zone hours, you will have the flexibility to work remotely* as you take on some tough challenges.


Primary Responsibilities:

  • Source Management
    • 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
  • Audit Management
    • 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
  • Other Responsibilities
    • 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


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:

  • 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


Preferred Qualification:

  • 1+ years of experience writing SQL queries


Soft Skills:

  • Solid leadership and interpersonal skills
  • Ability to work without a lot of direction
  • Team player
  • Solid communication skills
  • Organized
  • Ability to manage multiple projects at a time


*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 $112,700 - $193,200 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

 

 

UnitedHealth Group and its affiliated brands are 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.


UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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