Remote Claims Quality Manager

UnitedHealth Group; Dallas (TX); Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Health benefits

Incentive programs

401k contributions

Equity stock purchase

Job summary

UnitedHealth Group is seeking a National Remote Manager to lead the Claims Quality team. You will oversee audits, calibrations, and governance across Medical, Dental, and Pharmacy Claims, driving improvements and ensuring comprehensive quality controls.

The role requires 3+ years in healthcare claims, leadership experience, and strong Excel skills. Expect collaboration across departments and potential overtime, with a competitive benefits package.

Qualifications

• High School Diploma / GED or equivalent work experience.
• 3+ years of healthcare claims experience involving Medical, Dental, Pharmacy, or comparable claims operations.
• 2+ years of people-leadership experience, including direct-report management, SME, or formal team-lead responsibility.
• 2+ years of quality assurance, claims auditing, compliance monitoring, or operational quality experience.
• 2+ years of experience leading or supporting claims audits, quality monitoring, and remediation.
• Intermediate proficiency with Microsoft Excel, including filtering, sorting, pivot tables, charts.

Responsibilities

• Lead and manage the Claims Quality team, including setting priorities and workload.
• Oversee Claims Quality activities across Medical, Dental, and Pharmacy Claims, including audits and trends.
• Lead internal and external audit calibration and quality-governance activities.
• Monitor quality performance and analyze audit findings to identify risks and improvement opportunities.
• Lead corrective-action activities and root-cause analysis with remediation planning.
• Develop and strengthen operational and quality controls and governance.

Skills

Claims leadership

Quality assurance

Excel skills

Cross-functional collaboration

Auditing

Communication

Education

High School Diploma or GED

Tools

Microsoft Excel

Microsoft Word

PowerPoint

SharePoint

Teams

Job description

UnitedHealth Group is seeking a National Remote Manager to lead the Claims Quality team. You will oversee audits, calibrations, and governance across Medical, Dental, and Pharmacy Claims, driving improvements and ensuring comprehensive quality controls.

The role requires 3+ years in healthcare claims, leadership experience, and strong Excel skills. Expect collaboration across departments and potential overtime, with a competitive benefits package.