Quality Supervisor - Remote

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

Energize your career with one of Healthcare’s fastest growing companies.  

You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 10 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

This role supervises and manages daily operations of auditors and analyst team. Quality supervisor is responsible for end-to-end and all aspects of quality business process activities to include quality planning, quality assurance, quality control and quality improvement. Quality supervisor supports risk reduction, auditing life-cycle activities, cost and productivity savings, reporting, and quality improvement initiatives. Monitors performance and completes system analysis in specific areas of quality to include: Claims, Appointment Scheduling, Provider Data, Customer Service, and Appeals & Grievances

Sets team direction, resolves problems and provides guidance to members of own team. Adapts departmental plans and priorities to address business and operational challenges. Influences or provides input to forecasting and planning activities.

This role supports:

• Increase of quality metrics for operational business units
• Audit Calibrations with internal and external partners
• Cost / productivity savings
• Risk reduction
• Error / defect reduction
• Process waste reduction
• Continuous improvement efforts

This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm. It may be necessary, given the business need, to work occasional overtime.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Supervise and manage daily operations of auditors and analyst team
• Ensures data integrity, data security and process optimization
• Analyzes audits and provides feedback to reduce errors and improve processes and performance
• Leads process design and project implementation teams in process improvement activities
• Diagnose process improvement opportunities and develop solutions using principles of process excellence and related tools
• Responsible for quality reporting, analysis and audits and for developing plans and programs to support continuous quality improvement using applicable tools. May assist in the creation, implementation, and evaluation of Total Quality Management (TQM) programs
• May directly design and or facilitate training and evaluation of TQM programs and may oversee quality
• Utilizes six sigma methodologies to build and drive remediation plans to eliminate process defects
• Complete Audit the Auditor / program evaluation / reliability (consistency) audits / validity (accuracy of measures) audits / calibration audits
• Identifies risks and conduct risk remediation management  
• Performs research / data collection to support claims audits
• Conduct and manages claims audits
• Completes audit the auditor; Review the work of others to assess accuracy with process requirements 
• Schedules and conducts calibration audits with quality teams and operational teams
• Identifies and resolves operational audit problems using defined processes, expertise and judgment
• Provides coaching and feedback to team members, including error tracking and accuracy calculation
• Tracks appeals end to end and provides coaching for overturns 
• Communicates process / system changes, new expectations and initiatives within the department and organization
• Participates in communication with Business Operations management regarding trends in order to improve accuracy and documented business rules for incorporation into training programs, policies and procedures
• Implements quality strategies and recommends related improvements / enhancements
• Makes corrections and adjustments to work instructions, process maps and related documentation
• Consistently meets established productivity, schedule adherence, and quality standards
• Addresses special (ad - hoc) projects as appropriate; Performs special project audits and reviews as requested by other departments/regions

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:

• Bachelor's Degree (or higher)
• Understanding of basic quality programs
• 3 years of work experience in an office setting environment, using the telephone and computer as the primary instruments to perform job duties
• 2 years claims experience
• 2 years Team Lead/SME experience with demonstrated abilities in the following soft skills: Leadership and Emotional Intelligence
• 1 years six sigma experience
• 1 years process mapping experience
• 1 years auditing experience
• 1 years experience analyzing and solving customer problems
• 1 years healthcare experience
• Intermediate to advanced knowledge of Microsoft Excel (formatting, pivot tables/charts, pareto analysis, filtering, sorting, and editing data)
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm. It may be necessary, given the business need, to work occasional overtime
• Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.

Preferred Qualifications:

• 3 years auditing experience 
• 1 years experience supporting quality planning, testing parameters, and developing quality control procedures
• 1 years experience in quality auditing or compliance 
• 1 years team Lead/SME experience in quality 
• Six Sigma certification – White Belt
• Six Sigma certification – Green Belt
• Understanding of basic risk remediation management
• Knowledge of Billing / Finance and Eligibility processes, practices, and concepts

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.^SM

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $64,800 - $116,000. The salary range for Connecticut / Nevada residents is $71,400 - $127,400. 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

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.

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