Clinical Analyst

About This Role

This Clinical Analyst role proactively identifies solutions to complex requests and issues within UnitedHealthcare, focusing on supporting national and state healthcare accreditation standards and ensuring compliance.

Responsibilities

• Proactively identify solutions to nonstandard requests and issues
• Assist other areas of the team with unexpected or emergent tasks
• Conduct oversight audits, reviewing and comparing multiple data sources and historical records to identify discrepancies
• Support national and state healthcare accreditation standards, ensuring compliance with all regulatory and accreditation requirements
• Maintain consistent professionalism and openness in submitting completed work for review
• Operate independently with minimal supervision
• Professionally and proactively engage other departments to obtain required information

Requirements

• 2+ years of experience in Managed care
• Experience conducting oversight audits
• Solid understanding of national and state healthcare accreditation standards and regulatory compliance
• Demonstrates a positive, professional attitude toward receiving feedback
• Demonstrates solid organizational skills and effectively manages calendars and meeting coordination
• Proven ability to maintain consistent professionalism and openness in submitting completed work for review
• Proven ability to operate independently with minimal supervision
• Excellent written and verbal communication skills
• Proven ability to professionally and proactively engage other departments to obtain required information
• Reside in state of Florida

Qualifications

• 2+ years of experience in Managed care

Nice to Have

• Certified Professional in Healthcare Quality Certification (CPHQ), IHI certificate or Lean background
• Experience in HealthCare Quality
• Experience with navigating and analyzing reports in Microsoft Excel
• Solid knowledge of the Medicaid market
• Knowledge base of clinical standards of care, preventive health, and HEDIS measures
• Proven solid problem-solving skills

Skills

* Required skills

Benefits