Supervisor of Quality Assurance Operations HEDIS Remote

The Regional Municipality of Durham; Eden Prairie (MN); Remote; USD 71,000 - 141,000; Full time

Job summary

A leading health care organization seeks a Supervisor of Quality Operations to manage employee programs and ensure data accuracy for HEDIS medical records. This role requires HEDIS expertise and a Registered Nurse licensure, along with strong leadership and communication skills. Join a mission-driven team dedicated to improving health outcomes while enjoying flexibility with remote work options.

Benefits

Comprehensive benefits package

Equity stock purchase

401k contribution

Qualifications

• 3+ years of HEDIS experience.
• 2+ years of call center experience.
• 2+ years experience acting as team leader.

Responsibilities

• Lead a team of LPNs through HEDIS medical record collection.
• Ensure data meets HEDIS/STAR technical specifications.
• Conduct training on HEDIS/STAR measures and data collection strategies.

Skills

Training and presentation skills

Communication

Team leadership

Education

Bachelor's Degree

Registered Nurse (RN) licensure

Tools

Microsoft Office applications

Job description

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 Supervisor of Quality Operations is responsible for employee and program management on the CEQ team. This role leads a team of LPNs through year-round HEDIS medical record collection and provider outreach. The supervisor will act as a HEDIS SME for their staff, assisting with system, outreach, 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 Director 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.

Primary Responsibilities:

• Serve as subject matter expert to clinical staff
• Coordinate and account for daily business activities
• Perform quality assurance on data mining and provider outreach
• 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

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:

• Active and unrestricted licensure as a Registered Nurse (RN) in the state(s) of practice
• 3+ years of HEDIS experience
• 2+ years of call center experience
• 2+ years of experience acting as a team leader or SME
• Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Proven experience using Microsoft office applications, including databases, word-processing, Visio and Excel spreadsheets
• Access to high speed internet

Preferred Qualifications:

• Bachelor's Degree
• Certified Professional Coder
• 1+ years of supervisory or management experience
• Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Ability to be flexible in a continuously changing environment

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

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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 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.

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.