Clinical Admin RN Supervisor - Remote

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

The Supervisor of Quality Operations is responsible for management of the CPQ Provider Call Center team. This role leads a team of LPNs through year-round provider outreach for HEDIS® data collection.  The supervisor will act as a 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 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 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

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:

• Associate degree
• Registered Nurse
• 3 years of HEDIS® experience
• 2 years call center experience
• 2 years of experience acting as a team leader or SME
• Excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• 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
• 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

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California/Colorado/Connecticut/Nevada/New Jersey/New York/Rhode Island/Washington residents is $67,800 to $133,100 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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. 

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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.