Senior Value-Based Healthcare Data Analyst - Remote

The Senior Value-Based Healthcare Data Analyst is responsible for providing leadership and advanced analytical expertise to support healthcare quality, regulatory, and operational reporting initiatives, including HEDIS, EDPS, and encounter submissions. This position ensures accuracy, integrity, traceability, and compliance of complex, multi source healthcare data in accordance with NCQA, CMS, and state regulatory requirements. The role functions as a hands on technical leader, supervising analytic activities and coordinating efforts across Quality, Clinical, Informatics, IT, and Business Intelligence teams. Through collaboration and data driven insights, the position supports organizational objectives related to quality performance, affordability, and improved member outcomes. If you are located in Texas, you will have the flexibility to work remotely as you take on some tough challenges. Required Qualifications Bachelor’s degree in Health Informatics, Healthcare Administration, Data Analytics, Statistics, Computer Science, Information Systems, Mathematics, or a related discipline 3+ years of experience in healthcare data analytics, informatics, decision support, or managed care, including project leadership or analyst mentoring Experience supporting NCQA HEDIS Compliance Audits, quality measurement, and value-based care programs Experience supporting Medicare Advantage (Part C) and/or Health Insurance Marketplace products Experience extracting, reconciling, and validating data from EPIC Clarity and/or Caboodle Solid experience with data validation, ETL processes, and healthcare reporting tools (e.g., Tableau, Power BI, Crystal Reports) Knowledge of Medicare Advantage, including Stars, HEDIS, and regulatory reporting programs Advanced expertise in healthcare data analytics, quality measurement, and regulatory compliance Understanding of HEDIS Technical Specifications, NCQA requirements, and related compliance standards Proficiency working with claims and clinical data, including ICD-10-CM and CPT/HCPCS coding standards and healthcare data models Advanced proficiency in SQL and Microsoft Excel, with working knowledge of Word and PowerPoint Demonstrated ability to translate complex healthcare data into clear executive level insights that support quality and performance strategy Demonstrated ability to manage multiple priorities in a fast paced, deadline driven environment Proven verbal and written communication skills with exceptional attention to detail and analytical rigor Proven independently monitors data pipelines, submissions, and measure results for anomalies, gaps, or logic errors Preferred Qualifications Master’s degree in health informatics, Data Science, Analytics, Biostatistics, Healthcare Administration, or related field Relevant certifications such as CPHQ, RHIA/RHIT, Epic (Clarity/Caboodle/reporting), CAP, or SAS/SQL/data analytics 3+ years of experience with EDI encounter data (837), acknowledgments (277CA/999), and CMS risk adjustment files (MAO 002/004, RAPS) Experience reviewing work and providing actionable feedback", Solid expertise in healthcare analytics, quality metrics, and value-based care models Advanced knowledge of Epic Clarity architecture, refresh cycles, and EDW integration for BI/reporting Proficiency in Python, R, SAS, or similar programming/statistical tools Demonstrated ability to balance strategic thinking with hands‑on execution Proven problem‑solving skills with a focus on continuous improvement and proactive solution development 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 401(k) contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $91,700 to $163,700 annually based on full‑time employment. We comply with all minimum wage laws as applicable. 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. #J-18808-Ljbffr Optum