Supervisor of Quality Operations RN

$70,200 - $137,800/Yr

UnitedHealth Group - Oklahoma City, OK

Full-time - Mid Level

Oklahoma City, OK

Insurance Carriers and Related Activities

About the position

The Supervisor of Quality Operations RN at UnitedHealth Group is responsible for overseeing the Supplemental Data Entry and Primary Source Verification teams, ensuring the quality and completeness of clinical documentation processes. This role involves coordinating HEDIS® and STARs data gathering, performing quality medical record reviews, and assisting in the improvement of clinical documentation processes. The position requires strong analytical skills and the ability to communicate effectively with both clinical staff and corporate departments to enhance data quality and operational efficiency.

Responsibilities

• Serve as subject matter expert to clinical staff
• Coordinate and account for daily business activities
• Analyze data for possible discrepancies and deficits and document findings
• 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
• Support and improve communications between market and corporate departments
• 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
• Provide expertise to the corporate training department on STAR/HEDIS® measures and on the tools that support the collection of STAR/HEDIS® data
• Assist with team coordination of system changes, and system upgrades
• Develop process improvement
• Perform all other related duties as assigned

Requirements

• Registered Nurse
• 3+ years of HEDIS experience
• 3+ years of experience with data analysis/quality chart reviews
• Knowledge of HEDIS/STAR and Medicare measures
• Experience using Microsoft office applications, including databases, word-processing, Visio® and Excel® spreadsheets
• Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
• Access to high speed Internet

Nice-to-haves

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

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution