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HL7 Data Quality Analyst - UHC - Telecommute

UnitedHealth Group

Minnetonka, MN
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Job Details

745618 HL7 Data Quality Analyst UHC Telecommute

HL7 Data Quality Analyst - UHC - Telecommute (745618)

Position Description

The trend is clear: CMS Star ratings are improving, the market is becoming increasingly competitive, and members will continue to prefer Four Star and higher-rated plans (weighted by enrollment, 4+ Star plans serve almost 60 percent of enrollees). The financial return of achieving Star ratings of 4+ is substantial, enhances our brand in the market, and is commensurate with who we are as a company.


The UHG Stars reporting efforts are complex. The program is supported by diverse technologies and processes, delivered in some cases in siloes. Many of the processes are manual, and the teams that own individual processes work in different parts of the UHG organizations. 


Overall efficacy of Stars gap closure and reporting is hampered by the diversity of the supporting technologies and the complexity and diversity of the manual processes.


The ‘Stars Tech Team’ (project team) believes that it is possible to rationalize the technologies and processes that support Stars. The rationalization would both decrease the costs associated with Stars compliance and improve Stars scores as well.


The Clinical & Admin Data Services Management Team is focused on building clinical data exchanges with providers in order to improve data accuracy and quality of care as part of UHC’s collective clinical programs. This includes the focus to: Improve the completeness and timeliness of provider data Integration by leveraging industry leading standards for data sharing and technology enablement, delivery of an integrated prospective and retrospective HEDIS processing, and simplification of provider onboarding and data submission.


This role conducts quality validation of the end to end processes used to transform files received from providers to formats consumable by the Stars Data Mart (SDM) system and all related reporting. The role applies standard test practices and creates deliverables through hands on evaluation of the daily file processing. 


You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • Test and validate the mapping between the provider EMR information sent to CDSM and the data requirements of the overall program
  • Align test approach and test results with industry requirements including HEDIS, HL7, and other appropriate standards
  • Drive defect, incident and problem management by interrogating data bases and processing logs to investigate data integrity and accuracy issues
  • Provide daily updates to tracking tools (SharePoint file tracker) for reporting the implementation and operational progress
  • Work directly with all teams to ensure all mapping was correct and passes QA
  • Provide guidance for operational and delivery staff including offshore global teams
  • Communicate timely information to Operational Management including the status, issues, and risks of the current operational work queue
  • Validate  implemented file output and processing performance
  • Work with the provider technical resources to complete the mapping between the provider EMR information sent to CDSM and the data requirements of the overall program
  • Complete the assigned steps of implementing both CCDs and Flat files (Configure Ensemble, Unit Test, Peer Review, Promotion to production, production checkout and manually process files in production)
  • Define record layouts, mapping and supporting HEDIS documentation to transform provider files to custom and standard layouts used for supplemental data processing
  • Identify process improvements and lead/influence change, support and implement process improvements to ensure daily operations are as effective and efficient as possible
  • Ensure quality assurance processes are in implemented and followed driving toward very minimal defects

Required Qualifications:

  • 5+ years of test methodology experience for data integration scenarios
  • 5+ years of test plan development, test case development, test execution, and test report generation
  • 5+ years of analyzing Scope, Business Requirements document and Systems Requirements documents
  • 5+ years of experience creating strategy for functional and non-functional testing
  • 5+ years of experience creating Test Plans, Test Cases, Test Scripts and RTM
  • 5+ years of experience creating libraries for rapid test case development and automation
  • 3+ years SQL query development and automated execution for data validation in integration/warehousing and reporting domains
  • 3+ years of data warehousing, data processing, and data integration experience
  • 3+ years using testing platforms and tools

Preferred Qualifications:

  • QA experience in Healthcare, EMR integration, HIE integration, Medicare, HEDIS, STARS, Clinical Data Interfaces and other related Clinical Interoperability scopes of effort
  • Working knowledge of HL7, CCD and other clinical data standards
  • Able to communicate effectively with clients and executives 
  • Experience with complete software development life cycle
  • Ability to work under pressure and manage multiple tasks simultaneously
  • Critical thinking, problem solving skills

Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)


*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy



Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.



Job keywords: HL7, CCD, clinical data, quality data, interoperability, HEDIS, testing, SQL, data warehouse, SDLC, telecommute, UnitedHealth Group, UHG, UnitedHealthcare, UHC


Job Details

  • Contest Number745618
  • Job TitleHL7 Data Quality Analyst - UHC - Telecommute
  • Job FamilyInformation Technology
  • Business SegmentMedicare and Retirement

Job Location Information

  • Minnetonka, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelYes, 25 % of the Time
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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