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EPSDT Coordinator - Remote in KY - 2217377



Louisville, KY, USA · Lexington, KY, USA · Bowling Green, KY, USA
Posted on Friday, May 3, 2024

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

This position will be responsible for coordination of care for the EPSDT aged members to meet EPSDT quality and performance measure goals. Responsible for direction and guidance on Clinical Quality improvement and management of Performance Improvement measures. Responsible for the development and implementation of data collection methodology to meet or exceed minimum performance standards established by the regulator, reporting and analysis of clinical performance measures and performance improvement projects.

You’ll enjoy the flexibility to work remotely* from anywhere within the Commonwealth of Kentucky with up to 25% local in-state travel including meetings in the Louisville Office twice a month and attending some community and member facing events and conferences.

Primary Responsibilities:

  • Accountable owner of HEDIS Childhood and Adolescent measures including, but not limited to, WCV, IMA, CIS, and WCC
  • Provide annual evaluation of EPSDT program design and efficacy as well as development of work plans to address performance improvement
  • Develop and submit EPSDT requiring reporting including DMS and CMS reporting
  • Collaborate with multiple functions that may include Clinical, Physician Engagement, Member Experience, Benefit Design/Product, Compliance, Network, Behavioral Services, and Pharmacy as needed to drive the EPSDT quality improvement program
  • Initiate program improvement projects and activities to drive outcomes to impact EPSDT measures
  • Implement policies and procedures to align with program goals and compliance requirements
  • Represent the health plan and provide subject matter expertise as the EPSDT lead at internal clinical and quality meetings, regulatory meetings, and any relevant community partner meetings, workgroups, etc.
  • Examine data and/or information to identify inconsistencies, trends, other information needed
  • Analyze and interpret data or information to ensure they meet standards, are compliant and/or are accurate and complete
  • Manage key relationships (e.g., vendors, stakeholders, regulatory bodies) to ensure milestones are achieved and performance objectives are met
  • Participates in or coordinates with other department projects as needed
  • Assist in development of reporting tools including dashboards, data visualization for use internally and externally
  • Provide data support, including designing data collection formats and identifying appropriate sources of data, to the team or their leadership throughout the project and program life cycle, as appropriate

You’ll 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:

  • 3+ years of experience in the healthcare industry
  • 2+ years of experience in tracking, planning projects, working with large data sets, and making data-driven analytical decisions
  • 2+ years of experience focusing on childhood/adolescent initiatives
  • 1+ years of experience with demonstrated functional knowledge of process improvement, quality improvement, and change management
  • High level of proficiency with MS Excel
  • Moderate level of proficiency with MS Project, PowerPoint and SharePoint
  • Experience working with and leading cross-functional teams and projects
  • Reside within the Commonwealth of Kentucky
  • Travel 25% within the Commonwealth of Kentucky

Preferred Qualifications:

  • Electronic Medical Record, Health Information Exchange experience
  • Experience with HEDIS
  • Working with Medicare and Medicaid population experience
  • Population Health Management experience
  • Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
  • Solid analytical and problem-solving skills
  • Data visualization tool (eg: Tableau) experience
  • Ability to influence and work with internal and external stakeholders/resources to move projects and programs forward and overcome any challenges
  • Excellent communication skills both written and verbal

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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

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.