SDS Clinal Quality Analyst - HEDIS - Remote EST / CST

Primary Responsibilities

• Conduct comprehensive reviews of Section 5 submissions for completeness, accuracy, and compliance with NCQA standards
• Provide actionable feedback and detailed editing recommendations to improve documentation quality
• Audit Readiness & Compliance Support
• Ensure all supplemental data sources meet audit standards and are properly documented
• Identify risks, gaps, or inconsistencies and recommend corrective actions
• Stakeholder Communication & Follow-Up
• Collaborate with internal teams to communicate required updates and track progress
• Proactively follow up to confirm implementation of recommended changes
• Primary Source Verification (PSV)
• Perform PSV activities, including chart reviews, for non-standard supplemental data sources
• Validate data integrity and ensure adherence to audit requirements
• Data Tracking & Tool Management
• Accurately enter and maintain data within the SDS tracking tool
• Track Section 5 progress, PSV results, and auditor issue logs
• Ensure timely resolution and proper documentation of all audit findings
• Issue Identification & Resolution
• Monitor and manage auditor feedback and issue logs
• Support root cause analysis and corrective action tracking

Required Qualifications

• 2+ years of HEDIS audit experience
• Experience with Section 5 documentation
• Experience with Supplemental Data Sources (SDS)
• Able to work EST or CST schedule

Preferred Qualification

• Experience supporting NCQA audits

Core Competencies

• Exceptional attention to detail - ability to identify subtle discrepancies and ensure accuracy in documentation
• Strong written and verbal communication skills - clear, concise, and professional communication with stakeholders
• Responsiveness and accountability - ability to manage deadlines and follow through consistently
• Analytical thinking - ability to interpret audit requirements and apply them effectively
• Adaptability and quick learning - ability to rapidly understand tools, processes, and evolving audit requirements

Technical Skills

• Experience working with audit tracking tools or data systems
• Proficiency in data entry, tracking, and documentation management
• Familiarity with healthcare data, coding, and chart review processes preferred

Pay and Benefits

• The salary for this role will range from $60,200 - $107,400 annually based on full-time employment.
• We comply with all minimum wage laws as applicable.
• UnitedHealth Group is a drug-free workplace.
• Candidates are required to pass a drug test before beginning employment.