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Community and State Benefits Quality Manager - US Telecommute

UnitedHealth Group

Minneapolis, MN
Job Code:
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Job Details

748297 Community and State Benefits Quality Manager US Telecommute

Community and State Benefits Quality Manager - US Telecommute (748297)

Position Description

Position Description:

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

You dream of a career where you can make an impact and help people live healthier lives. The QuEST (Quality.Every.Single.Time) organization is passionate about the pursuit of operational quality. Join us, and start doing your life's best work while developing your expertise as a quality professional. Positions in this function are responsible for all aspects of quality assurance within the Benefits and Claims job family. Role responsibilities include overseeing operations of an audit teams and drive remediation collaboration with processing and other upstream / downstream operations partners. Represent functional area of responsibility with director level leadership.

This function supports the C&S Benefit Configuration and Claim Operations teams by leading a team of C&S Quality Reviewers and Analysts ensuring that goals are consistently met or exceeded. This role also has responsibility for managing audits for complex clients with high visibility as well as managing various other projects related to Benefits and Claims Quality.

This position will provide direct leadership to a team of C&S Quality Reviewers and Analysts.

Primary Responsibilities:
  • Work independently while keeping Associate Director well informed
  • Responsible for positive team culture as measured by Vital Signs Employee Engagement and Manager Effectiveness Index score
  • Lead and / or oversee remediation improvement through use of advanced quality skills, tools and analysis
  • Ownership and driver of management quality goals, while managing audit teams to meet current year goals
  • Quality program administration and program development. Innovate, expand, and improve existing programs and / or identify new opportunities to improve Customer and Business partner quality
  • Resolve escalated and complex issues with business partners
  • Sets team direction, resolves problems and provides guidance to members of own team
  • Work to assure current audits meet customer requirements, business and process changes
  • Realign or reprioritize work and or people to manage what is value add or critical to customer or business
  • Drive department level accountability and assure audit results are properly documented
  • Meet audit close deadlines and work with analyst to provide timely reporting to senior leadership
  • Influences or provides input to forecasting and planning activities
  • Interact both formally (presentations) and informally with all levels of leadership
  • Collaboratively work with leadership / director to identify and execute individual development goals and action plans
  • Be assertive about identifying and remediating personal professional development
  • Assure entire reporting structure experiences the value for personal professional development
  • Provide coaching and support to team members, ensuring performance issues are addressed timely and appropriately
  • Lead / participate in special projects
  • Lead and maintain all United Operating Model standards and expectations
Required Qualifications:
  • High School Diploma / GED (or higher)
  • 2+ years prior Medical / Healthcare insurance supervisory experience (Must have proven skill in supervising people and have sufficient experience to train supervisors)
  • 2+ years of claim processing, quality auditing or health insurance knowledge
  • Prior experience and demonstrated competency of C&S Operations, QuEST or CSP claim processing
  • Proficient in Microsoft Word (editing existing document templates, creating formal communications and usage for note taking, organization, etc.)
  • Proficient in Microsoft Excel (using filters, spreadsheet editing, and data entry into existing cell, work within tables, V Lookups, Pivot Tables, utilize formulas)
  • Proficient in Microsoft PowerPoint (completing existing templates, creating formal presentations)
Preferred Qualifications:
  • Bachelor's Degree
  • Prior Quality experience

Soft Skills:

  • Build / Maintain / Manage Relationships with Operations Stakeholders
  • Requires excellent interpersonal and communication skills
  • Ability to effectively interact with business partners, audit firms, and all levels of staff
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.

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.

Keywords: medical, healthcare, stakeholderm C&S Operations, Quest, CSP, claims, Word, Excel, PowerPoint, quality experience, Community and State Benefits Quality Manager

Job Details

  • Contest Number748297
  • Job TitleCommunity and State Benefits Quality Manager - US Telecommute
  • Job FamilyClaims
  • Business SegmentUHC Benefit Ops - Corporate

Job Location Information

  • Minneapolis, MN
    United States
    North America
  • Other LocationsDallas, TX
    Tampa, FL
    Phoenix, AZ
    Hartford, CT

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelManager
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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