[Hiring] Supervisor of Quality Operations @UnitedHealth Group
Role Description
The Supervisor of Quality Operations is responsible for management of the CEQ National Remote Data Mining and Provider Contact Center teams. This role leads a team of LPNs through year-round provider outreach for HEDIS® data collection. The supervisor will act as a systems, call center, and HEDIS® SME for their staff, assisting with call and technical specification questions. Through quality reviews, call monitoring, and quality and productivity reporting, the supervisor will ensure all data submitted to the health plan meets HEDIS®/STAR technical specifications for medical records and provide actionable feedback to their staff to promote continued success. This role assists the Manager of Quality Operations with communication of prioritization, strategy, and best practices.
You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
• Serve as subject matter expert to clinical staff
• Coordinate and account for daily business activities
• Perform quality assurance on remote data mining
• Perform quality assurance on provider calls
• Perform quality assurance on the data entry and over read of non-standard supplemental data obtained from medical record review
• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS®/Star measures
• Review scanned records and data entry into supplemental data applications
• Support chart chase process by requesting records from provider’s offices as needed
• Maintain education/knowledge base of HEDIS®/STARs standards and guidelines
• Pull and review quality and productivity reporting
• Conduct training on HEDIS®/STAR measures, HEDIS®/STAR data collection software, and data collection strategies
• Assist with team coordination of system changes, and system upgrades
• Participate in debrief activities and continual process improvement exercises
• Perform all other related duties as assigned
Qualifications
• Associate degree
• Registered Nurse
• 3+ years of HEDIS® experience
• 2+ years of experience acting as a team leader or SME
• Experience using Microsoft office applications, including databases, word-processing, Visio® and Excel® spreadsheets
• Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Access to high-speed internet
Preferred Qualifications
• Bachelor’s Degree
• Certified Professional Coder
• 2+ years of call center experience
• 1+ years of supervisory or management experience
• Proven ability to be flexible in a continuously changing environment
Physical & Mental Requirements
• Ability to lift up to 25 pounds
• Ability to sit for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving
Pay and Benefits
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 $71,200 to $127,200 annually based on full-time employment.
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.
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The Supervisor of Quality Operations is responsible for management of the CEQ National Remote Data Mining and Provider Contact Center teams. This role leads a team of LPNs through year-round provider outreach for HEDIS® data collection. The supervisor will act as a systems, call center, and HEDIS® SME for their staff, assisting with call and technical specification questions. Through quality reviews, call monitoring, and quality and productivity reporting, the supervisor will ensure all data submitted to the health plan meets HEDIS®/STAR technical specifications for medical records and provide actionable feedback to their staff to promote continued success. This role assists the Manager of Quality Operations with communication of prioritization, strategy, and best practices.
You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
• Serve as subject matter expert to clinical staff
• Coordinate and account for daily business activities
• Perform quality assurance on remote data mining
• Perform quality assurance on provider calls
• Perform quality assurance on the data entry and over read of non-standard supplemental data obtained from medical record review
• Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS®/Star measures
• Review scanned records and data entry into supplemental data applications
• Support chart chase process by requesting records from provider’s offices as needed
• Maintain education/knowledge base of HEDIS®/STARs standards and guidelines
• Pull and review quality and productivity reporting
• Conduct training on HEDIS®/STAR measures, HEDIS®/STAR data collection software, and data collection strategies
• Assist with team coordination of system changes, and system upgrades
• Participate in debrief activities and continual process improvement exercises
• Perform all other related duties as assigned
Qualifications
• Associate degree
• Registered Nurse
• 3+ years of HEDIS® experience
• 2+ years of experience acting as a team leader or SME
• Experience using Microsoft office applications, including databases, word-processing, Visio® and Excel® spreadsheets
• Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Access to high-speed internet
Preferred Qualifications
• Bachelor’s Degree
• Certified Professional Coder
• 2+ years of call center experience
• 1+ years of supervisory or management experience
• Proven ability to be flexible in a continuously changing environment
Physical & Mental Requirements
• Ability to lift up to 25 pounds
• Ability to sit for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving
Pay and Benefits
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 $71,200 to $127,200 annually based on full-time employment.
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.
Apply tot his job
Apply To this Job