Manager, Quality Field Operations – Remote in Missouri or Kansas

Requisition Number: 2302987
Job Category: Medical & Clinical Operations
Primary Location: Maryland Heights, MO, US
(Remote considered)

Doctor consulting nurse at nurse station.

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 resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This position will be responsible for supervising a team of outbound call center agents and/or field-based staff. The team is responsible for working with medical practices to coordinate outreach to Medicare Advantage members to ensure the recommended preventive health screenings are completed and gaps in care are addressed. Travel is required both in state and out of state to visit physician practices and field-based staff as needed.

If you are located in Missouri or Kansas, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities:

  • Sets team direction, resolves problems, and provides guidance to members of the team
  • Ensures team meets established performance metrics, performance guarantees, and quality standards
  • Manages administrative and clinical operations consisting of field based and/or contact center-based staff
  • Manage relationships with physician practices
  • Manage implementation of new physician practices and deployment of resources
  • Manage client relationships
  • Collaborate with cross functional teams on practice specific strategies to improve Medicare Stars ratings
  • Takes the lead role in setting direction and participating in or developing new programs
  • Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff
  • Work most often impacts a large business unit, or multiple markets/sites, or at the segment/market group level for functional staff positions
  • Drives performance through audits and coaching to team personnel to ensure products and services fully meet the client expectations while maintaining efficient and profitable operational delivery
  • Assure the onboarding and training of new and existing staff to support product growth and service enhancement
  • Fiscal and operational discipline and management
  • Weekly commitment of 80% travel for business meetings (including client/health plan partners and provider meetings) and 20% remote work

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:

  • 2+ years of supervisory experience
  • Medical / Healthcare industry experience
  • Customer service management experience
  • Knowledge of Benefits and Claims Systems and Operations
  • Proven solid inbound and outbound telephonic skills
  • Proven teambuilding and leadership skills
  • Proven effective skills in motivating and mentoring others
  • Proven excellent communication and presentation skills
  • Proven computer skills and technical aptitude, familiar with MS Office
  • Demonstrated ability to identify with a consumer to understand and align with their needs and realities
  • Demonstrated ability to perform effective active listening skills to empathize with the customer to develop a trust and respect
  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done to achieve a goal(s)
  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer
  • Weekly commitment of 80% travel for business meetings (including client/health plan partners and provider meetings) in Kansas, Missouri and Nebraska and 20% remote work

Preferred Qualifications:

  • Medicare Stars experience
  • HEDIS experience
  • Project management experience
  • Quality or Six Sigma experience
  • Experience in utilization review, concurrent review and/or risk management
  • Knowledge of call center performance measurement systems and metrics (i.e. ASA, AHT, Service Level)
  • Proven Project/Product coordination/management skills 
  • Proven background in managed care
  • Proven solid organizational skills and multitasking abilities will be keys to success

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment

Additional Job Detail Information

Requisition Number 2302987

Business Segment Optum

Employee Status Regular

Job Level Manager

Travel Yes, 75 % of the Time

Country: US

Overtime Status Exempt

Schedule Full-time

Shift Day Job

Telecommuter Position Yes

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