Supervisor of Quality Operations RN
Company: Optum
Location: Cheyenne
Posted on: March 1, 2025
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Job Description:
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 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.
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The Supervisor of Quality Operations is a subject matter expert for
the Supplemental Data Entry and Primary Source Verification RNs and
LVNs, assisting with growth and development, daily direction and
requests as needed. -This role assists with the coordination of
HEDIS - and STARs data gathering process within EMR systems,
DataRAP and additional applications as needed. -This role evaluates
the quality and completeness of clinical documentation processes by
performing quality medical record reviews, assisting in the
improvement of the clinical documentation process, maintaining
accurate records of review activities, ensuring all data submitted
to the health plan meets the HEDIS -/Star technical specifications
for medical records. -This role assists the Manager of Quality
Operations with communication of prioritization, strategy and best
practices.
If you are located in CST, EST, or MST, you'll -enjoy the
flexibility to work remotely * from anywhere within the U.S. as you
take on some tough challenges. -
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Primary 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
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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
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
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Preferred Qualifications: -
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
*All employees working remotely will be -required -to adhere to
UnitedHealth Group's Telecommuter Policy -
Colorado 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.
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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.
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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.
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UnitedHealth Group is a drug-free workplace. Candidates are
required to pass a drug test before beginning employment.
Keywords: Optum, Cheyenne , Supervisor of Quality Operations RN, Healthcare , Cheyenne, Wyoming
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