Quality Improvement STARS Call Center Supervisor - Remote

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

The Quality Improvement Supervisor is responsible for coordinating and implementing the HEDIS and STAR’s  call center strategy and gap closure and works in collaboration with the Maanger of STARS Quality Call Center Operations and Director of Quality to develop strategies for achieving a 5 STAR rating.   Directly responsible to manage teams of clinical and nonclinical staff who perform central call initiatives such as performing telephonic outreach to retrieve and/or disseminate appropriate information as relates to member care and CMS quality measures as well as to resolve quality gaps.   The Quality Improvement Supervisor provides direction and support to various corporate interdepartmental teams and CDOs in the implementation of strategies for closing care gaps.  This role reports initiatives to quality field teams across multiple CDOs. This role works closely and collaboratively with various functional areas of the healthcare and IT delivery systems to achieve the goals and objectives of the Quality Improvement Program. 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities:

• Provides leadership and support in establishing and executing the Quality Performance Initiatives in alignment with corporate goals
• Supervises and coordinates the work activities of the team
• Supervises a team that conducts a high volume of outbound calls to assist members, evaluate current health status, discuss  non-compliance to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Calls are made primarily using an auto dialer requiring precision to detail and adaptability to type of response needed. Team also answers inbound calls from members and assists them with their inquiries
• Monitors productivity, call center metrics, documentation and call quality to ensure established standards are met
• Collaborates with clinical support staff to execute the implementation of the clinical quality initiatives to close HEDIS and STAR gaps as defined by the enterprise
• Work with IT on the interpretation of technical specifications and impact of HEDIS/STAR Measures related to data collection applications and reports utilized for the support of HEDIS/STAR measures
• Work with internal teams to accurately report on data collection as it refers to HEDIS gap closures and STAR measures
• Monitor and analyze large volume of electronic assessment submissions for possible data deficit issues. Utilize internal audit tracking tools for review and validation of data integrity
• Update Project templates, staff training materials, and Work Plans with assigned responsibilities
• Performs 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:

• Registered Nurse with Undergraduate degree or equivalent experience
• Unrestricted Nursing License in State of Residence
• 5 years of experience within a healthcare environment including experience within a managed care setting, including 3 years of management experience
• 3 years of experience with data analysis
• Experience in a call center environment - leadership/supervisor experience is a plus
• HEDIS/STAR experience or participation with regulatory reporting
• Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
• Advanced experience using Microsoft office applications, including but not limited to databases, word-processing, spreadsheets, and graphical displays
• Proven capability to work with people at all levels in an organization
• Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Proven excellent communication, writing, proofreading and grammar skills
• Proven solid attention to detail and accuracy, excellent evaluative and analytical skills
• Proven solid teamwork, interpersonal, verbal, written, and administrative and customer service skills
• Demonstrated effective organizational skills
• Availability to work any schedule between 7am-8pm CST due to nationwide account in multiple time zones

Preferred Qualifications:

• BSN degree or related field  
• CPHQ Certification
• CHCQM Certification
• 3 years of process management experience
• Healthcare Quality Improvement experience

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

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

California, Colorado, Connecticut, Hawaii, Nevada, New York, New Jersey, Rhode Island, Washington or Washington, D.C. Residents Only: The salary range for this role is $70,200 to $137,800 annually. 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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

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

Salary : $70,200 - $137,800