Sign In
 [New User? Sign Up]
Mobile Version

Senior Data Configuration Analyst - Minnetonka, MN

UnitedHealth Group

Minnetonka, MN
Job Code:
Apply on the Company Site
  • Save Ad
  • Email Friend
  • Print
  • Research Salary

Job Details

745617 Senior Data Configuration Analyst Minnetonka MN

Senior Data Configuration Analyst - Minnetonka, MN (745617)

Position Description

UHC M&R Stars


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.


Program Background:

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 supports the teams engaging directly with the providers and once the agreements are in place establishes the data mapping definitions between the EMR system records that will be transmitted to CDSM and the eventual downstream systems that record the appropriate information.  The role understands the technical and detailed data requirements and defines the business rules and mappings that are used to configure and process the files automatically.  Once the mappings have been operationalized, this role also supports operations to resolve issues, discrepancies, and to ensure the quality of information received downstream is intact.  The Deployment Lead also interacts with the providers and their technical staff to resolve issues in both development and production scenarios.


Primary Responsibilities:

  • 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
  • Act as the technical analyst to collaborate with market management to identify and engage key providers to collect member encounter and clinical data
  • Act as the primary technical resource to educate providers on the required file standards and submission processes
  • 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
  • Configure and map interfaces using the Ensemble versions established for UHC M&R PDAT Team (HQPAF version 1 and ACC version2 of Ensemble)
  • Develop and maintain technical processes to transform and enrich provider files used for supplemental data processing
  • Assist with defect, incident and problem management by interrogating data bases and processing logs to investigate issues
  • Provide daily updates to tracking tools (SharePoint file tracker) for reporting the implementation and operational progress
  • Complete all HEDIS documentation
  • Complete necessary requirements and technical mapping specifications to enable coding in the transformation engines
  • Support all CCD submissions that are sent through SFTP / Bulk load processing
  • Resolve configuration and mapping issues acting as the liaison between various teams internal and client facing
  • Communicate timely information to Operational Management including the status, issues, and risks of the current operational work queue
  • Utilize customer service skills to resolve issues with internal and external organizations
  • 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 implemented and followed driving toward very minimal defects
  • Effectively manage multiple priorities at the same
  • Anticipate daily needs of the client/program
  • Ensure appropriate documentation is developed and maintained to describe operational processes for both the client’s needs and for training purposes
  • Analyze and define internal and external customer requirements for clinical data exchange
  • Manage the implementation of data through UHC systems
  • Partner with technical teams to optimize and automate provider onboarding, file ingestion, end to end provider life cycle management, dash-boarding, and reporting processes
  • Resolve configuration and mapping issues and drive prevention of future defects
  • Assist with defect, incident and problem management by interrogating data bases and processing logs to investigate issues
  • Utilize customer service skills to resolve issues with internal and external organizations

Required Qualifications:

  • Bachelor's degree in computer science; related field or equivalent work experience
  • 8+ years of data warehousing, data processing, data integration or health data interoperability experience
  • 5+years of experience with file/data processing and data integration automation and optimization
  • 5+ years of clinical data management and system mapping experience
  • 4+ years of experience with integration technologies including: Intersystems Ensemble Application Integration Tool, Infor Cloverleaf Integration Suite, Mirth, Cloverleaf, Rhino scripting
  • Experience in healthcare vertical including EMR, Health Insurance, Acute care, Post-Acute, Health Systems, and HIE
  • Experience with writing business requirements for clinical data applications and data interfaces
  • Experience in SNOMED-CT, DICOM, HIPPA, ICD 9,10 & LOINC codes
  • Experience with standard health care file format including CCD, CCDA, HL7 etc.
  • General understanding of standard health care file formats included CCD,CCDA, C32, HL7, ORU, etc.
  • Experience with integration technologies including: Ensemble, Cache, HealthShare or other interoperability platforms such as Mirth, Orion Rhapsody, Cloverleaf, eGate, JCAPS, InterSystems, Optum, etc.
  • Experience using Agile and DevOps delivery methods
  • Experience with complete software development life cycle
  • Proficient with MS Office Suite (Word, Excel, PowerPoint)
  • Proficient at using SharePoint
  • Healthcare experience, clinical data analysis experience
  • Member encounter/clinical data experience
  • Understanding of HIPAA and PHI compliance
  • Healthcare experience, clinical data analysis experience
  • Medicare experience
  • General understanding of CMS Stars ratings and HEDIS

Preferred Qualifications:

  • Advanced degree in information science; related field or equivalent work experience
  • Knowledge of leading Provider EMR systems including Epic, Cerner, GE, Allscripts, Meditech or HIE
  • Experience with both common and emerging interoperability standards such as HL7 V2.x, as well as CCD, C - CDA XML V3, IHE profile, FHIR

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)



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: HEDIS, Stars, data warehousing, data processing, data integration, health data, coding, HIPAA, PHI, Epic, Cerner, GE, Allscripts, Meditech, HIE, Minnetonka, MN

Job Details

  • Contest Number745617
  • Job TitleSenior Data Configuration Analyst - Minnetonka, MN
  • 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 LevelDirector
  • ShiftDay Job
  • TravelYes, 25 % of the Time
  • Telecommuter PositionNo
  • 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.

Powered ByLogo

Featured Jobs[ View All ]

Featured Employers [ View All ]