Job Description

EMR Integration Solution Consultant

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The EMR Integration Solution Consultant is responsible for serving as the national Subject Matter Expert (SME) in EMR builds and quality-related functionalities to support the successful rollout of Cozeva integrations and IPA operations across key markets. This position plays a critical role in bridging clinical, technical, and operational domains to drive standardization, improve STAR ratings, and enhance quality performance.

Key responsibilities include:

• Evaluating and optimizing EMR capabilities to support scalable, quality-driven workflows
• Leading EMR build and integration efforts
• Driving data-informed operational improvements across multiple markets
• Refining and translating business and system requirements into actionable solutions
• Ensuring accurate and seamless data flow across platforms to support compliance and reporting

This role will also be accountable for interpreting HEDIS specifications, guiding user acceptance testing (UAT), and aligning business reporting needs with system capabilities. By ensuring consistency, data integrity, and compliance, the role will be instrumental in enabling smooth transitions and delivering measurable quality outcomes across the enterprise.

Youll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Identifies and integrates new datasets from various sources to be leveraged throughout the organization to meet business needs, as well as provides continuous management and maintenance of the data
• Collaborate with various stakeholders to understand quality business needs and provide data driven insight for process improvements to drive data completeness and accuracy
• Predicts emerging customer needs by discovering trends and anomalies in the data and identifying root causes and drivers for improving the overall and delegated member experience, member retention, member performance and STARs
• Designs data modeling processes, creates algorithms and predictive models to extract data for business needs, and helps analyze data and shares insights across the organization
• Develops the strategy for and leads various multi-data source projects that include analyzing, reviewing, forecasting and trending Stars related and other member feedback data for key business decision leaders across Optum Care Delivery Organizations
• Translates highly complex concepts in ways that can be understood by a variety of audiences. (e.g., Tell a Story with the Data for business leadership and non-analytics audiences)
• Executes team and department projects from a data perspective, including sourcing and cleaning data
• Develops pioneering approaches to capturing and reporting data trending
• Partners with quality strategy leads, Quality team partners, and CDOs to develop innovative analytics solutions. Includes partnering with other data analytics leads to implement standard and innovative ways to report Stars measure performance by CDO including verbatims and sentiment analysis
• Leads large, complex analysis projects to achieve key business objectives including member survey analytics across multiple data sets and surveys
• Produces innovative solutions driven by exploratory data analysis from unstructured, diverse datasets that leads to the development and implementation of a framework for Quality data analytics & QA process of EMR Inbound and outbound data from Quality Business Perspective
• Serves as Stars data subject matter expert in cross-functional programs and efforts
• Understands the complexity within functions, relationships, and contractual obligations with the ability to balance competing priorities
• Performs all other related duties as assigned

Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+ years of CMS Star Rating program experience in healthcare quality programs
• 2+ years of experience building quality EMR capabilities
• 2+ years of years interpreting HEDIS specifications
• 2+ years of experience in program or project management demonstrating proficiency in handling multiple projects including prioritization, planning, and task delegation
• Experience with NCQA audit requirements
• Proven intermediate Excel skills with the ability to perform functions such as a VLookup
• Demonstrated cross functional partnership with clinical operational workflows and documentation practices
• Proven solid knowledge of extracting and developing key consumer insights within a population
• Experience managing and integrating data connections between multiple data sources
• Demonstrated track record of solid analytical, problem solving and decision-making skills
• Ability to thrive in an environment that is tasked with providing data-driven decision support and business intelligence that is timely, accurate and actionable
• Highly motivated with ability to work in a fast paced, changing environment
• Proven solid communication skills (written and verbal); ability to present communication plans to customers

Preferred Qualifications:

• Health plan, healthcare or clinic operations experience

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 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves 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.

UnitedHealth Group 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.

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

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