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Quality Assurance Research Specialist - Columbia, MD

UnitedHealth Group

Columbia, MD
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Job Details

738456 Quality Assurance Research Specialist Columbia MD

Quality Assurance Research Specialist - Columbia, MD (738456)

Position Description

Position Description:

Turn on the news on any night of the week and you’re likely to hear about the changes that are sweeping through our health care system. It’s dramatic. It’s positive. And it’s being led by companies like UnitedHealth Group. Now, you can take advantage of some of the best resources and tools in the world to help serve our members by ensuring the quality of our customer service operations and the customer experience. This is no small opportunity. 

This role is equally challenging and rewarding. The entire customer service operation is reliant on your ability to audit calls and provide feedback to team members, as well as analyzing information to build recommendations

Primary Responsibilities:

    • Responsible for researching all Complaints and Grievances inquiries
    • Responds and Performs routine and or structured requests.  
    • Responsible for quality assurance by conducting audits of calls for all Customer Service Scheduling Coordinators in the inquiry box.
    • Collect and interpret research results and submit final feedback from inquiries
    • Provide feedback to scheduling coordinators, supervisors and managers on research and audit results in ICBM (Business Manager).
    • Provide verbal and/or written feedback directly to scheduling coordinators and TeamCare leadership staff on research and audit results.
    • Utilize relevant information resources (e.g., scheduler, ICBM, training, Quality specialists, footprint) to conduct research searches
    • Analyze information and utilize to build recommendations to reduce errors and improve processes and performance.
    • Create, maintain and track reports in relation to performance.
    • Advises Management of trends that are observed so residual trainings can be performed.
    • Serve as a subject matter resource to scheduling coordinators, supervisors and management staff.
    • Uses existing procedures and facts to solve routine problems or conduct routine analyses
    • Has basic knowledge of theories, practices and procedures in a function or skill.
    • Collaborate with internal and/or external stakeholders to redesign and/or modify original research plans based on initial findings and results.
    • Will act as a resource and mentor to others as it pertains to quality monitoring and process coaching.
    • Collaborate with Training, TeamCare management, Member Experience and peers when needed, in all locations (TN, MD, and CA and India). 
    • Ability to monitor several new/on-going projects, including calls, URS, Concierge, Helpdesk, Specialty, etc.
    • Responsible for using approved department forms to document quality reviews.
    • May assist with the development of call center training and quality assurance processes.
    • May work with QA/Training, TeamCare leadership and senior management on coaching, training, and the development of scheduling coordinators.
    • Supports and suggests improvements/recommendations to meet the highest level of customer satisfaction.
    • Must be able to manage call monitoring activities for a high-volume call center.
    • Follows department QA plan to ensure quality customer service.
    • Ensures that metrics are met for the amount of calls monitored for each coordinator and the amount of disposition audits performed.
    • Extensive work experience, possibly in multiple functions.
    • Work does not usually require established procedures.
    • Must be able to work independently.
    • Must be able to multi-task.
    • Coordinates others' activities.
    • Other duties as assigned.

    Required Qualifications:

      • High School Diploma/GED or higher
      • 1+ years of Call Center experience member/employee engagement (direct or indirect).
      • Experience with coaching and mentoring with the purpose of improving call quality
      • 6+ months experience handling escalated calls.
      • Proficient computer skills including Microsoft Suite (Word to create and edit documents, Excel to create, edit spreadsheets and PowerPoint to create and edit presentations).
      • Experience with Call Center technology (i.e. auto dialer, work force management software).
        Experience with researching to develop solutions

      Preferred Qualifications

      • Experience in customer service call auditing, preferably in health care
      • Claims processing experience
      • Bilingual in English/Spanish
      • Business Manager Experience with Quality auditing tools.

      Soft Skills:

      • Excellent interpersonal skills with the ability to adapt communication to audience
      • Ability to coach and develop staff in a positive manner
      • Excellent verbal and written communication skills
      • Professional and positive display of compassion and commitment to service excellence
      • Must have the ability to prioritize assignments in a fast-paced environment
      • Ability to perform tasks with minimal supervision, a high level of accuracy, and strong attention to detail
      • Ability to motivate and encourage others
      • Excellent organizational skills and the ability to work in a fast-paced, teamwork environment.
      • Must be a team player and have the ability to interact across functionally within the organization.

      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

      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.

      Key words: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, healthcare, office, phone support, training class, customer service advocate, customer service rep, SME, Senior, SR, Quality, Audit

      Job Details

      • Contest Number738456
      • Job TitleQuality Assurance Research Specialist - Columbia, MD
      • Job FamilyCustomer Services
      • Business SegmentOptumCare

      Job Location Information

      • Columbia, MD
        United States
        North America

      Additional Job Detail Information

      • Employee StatusRegular
      • ScheduleFull-time
      • Job LevelIndividual Contributor
      • ShiftDay Job
      • TravelNo
      • Telecommuter PositionNo
      • Overtime StatusNon-exempt

      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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