Senior Manager, Business System Analysis - Remote

Optum is a global leader in health care innovation, seeking a Senior Manager for Business System Analysis. This role is responsible for ensuring the completeness and timeliness of clinical data from providers and vendors, driving initiatives to improve data collection processes and achieve HEDIS targets.

Responsibilities:

• Must be able to cultivate Solid Partnership with UHC all Lines of Business Operational Peers Works as a technical liaison in cohesion with operational counterpart to execute acquisition of data from providers, specialists, and other entities
• Leads cross functional efforts on the technical side for process improvement and communication to data acquisition team leadership
• Directly involved with elevated, prioritized provider group issues to help resolve and drive solutions for data collection
• Monitors, Reports, and communicates process flow for intake of data and timeliness of processing
• Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data
• Manage issues by proactively reporting progress and working with cross functional peers to resolve
• Serve as Provider Data Acquisition SME to internal local teams and external providers for all data acquisition processes
• Serve as market SME to campaign leaders ensuring campaigns meet local market requirements and nuances
• Oversight and project management responsibilities for the successful implementation of clinical data exchange implementations with key providers (may include capturing data from various data sources including EMR (Electronic Medical Record), HIE (Health Information Exchange), data marts, etc.)
• Manage implementations through effective use of project plan and project management discipline
• Engage with providers to discuss requirements and process for setting up clinical data exchanges
• Collaborate with market management to identify and engage key providers to collect member encounter and clinical data
• Lead cross-functional teams to drive projects to completion within committed timelines
• Communicate effectively to manage expectations of clients and providers
• Provide timely and accurate progress updates and reporting related to current project status for each implementation
• Identify, manage, and mitigate risks and issues impacting implementations
• Participate in development, maintenance, and improvement of implementation processes

Requirements:

• 5+ years of clinical data analysis experience
• Member encounter/clinical data experience
• Experience in working with HL7 and FHIR clinical data standards
• Understanding of HIPAA and PHI compliance
• Proficient in understanding HEDIS requirements as it relates to data submissions and performance
• Proficient at using SharePoint, Rally, and Service Now
• Demonstrated ability to manage multiple clinical submitter implementations at one time
• Demonstrated ability to adapt to a fast-paced, quickly changing environment
• Demonstrated ability to effectively implement and lead change management
• Proven solid communication skills
• Proven solid leadership skills
• Proven client relationship management skills
• Technical and business experience regarding clinical quality specifications with the ability to speak with confidence
• Provider-facing experience
• EHR/Vendor system experience
• General understanding of CMS Stars ratings and HEDIS