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Clinical Oversight Support Quality Analyst- Telecommute job in Chicago at UnitedHealth Group

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Clinical Oversight Support Quality Analyst- Telecommute at UnitedHealth Group

Clinical Oversight Support Quality Analyst- Telecommute

UnitedHealth Group Work from Home/Remote Full-Time

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)



You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.



Primary Responsibilities:




  • Maintains Clinical Business & Performance Oversight (CBPO) monitoring tools and libraries in accordance with NCQA, Federal, and State requirements in partnership with oversight teams, line of business stakeholders, risk management, compliance, UHN designees, and legal counsel

  • Actively participates in reviews and discussions as accreditation and regulatory requirements are evaluated for applicability and awareness and helps shape delegate requirements to comply with said authorities

  • Supports education and implementations of accreditation and regulatory clarifications and revisions to the appropriate CBPO team leaders and front-line staff

  • Supports the Provider Communication process for delegate notifications by working with appropriate business areas to facilitate the approvals from United business leads, including Provider Communications and working with the CBPO teams to distribute to the impacted delegates

  • Provides guidance, remediation, and post follow-up outcomes communication to mitigate operational risk of repeat corrective action plans, fines and/or penalties from regulators

  • Analyze and investigate, problem resolution; evaluating outcomes and providing ongoing feedback to appropriate delegate and internal staff/committees; providing support at Regulatory and Accreditation surveys, as needed



A Day in the Life: Clinical Oversight Support Quality Analyst




  • Log into computer, review daily calendar, and check email/voice messages

  • Prioritize daily work utilizing critical thinking skills

  • Participate in monitoring activities 

  • Provide support and guidance to team members as needed

  • Organize, request, and follow up on audit material to be collected from external stakeholders

  • Collaborate with team members to resolve issues related to monitoring tools and libraries

  • Facilitate clarification and training meetings with CBPO and other United business partners to address questions, remove barriers and provide direction

  • Attend necessary meetings and/or training sessions

  • Actively participate in projects by attending meetings, gathering information, analyzing data and other assigned tasks

  • Share ideas and techniques for best practices with team and leaders





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:




  • Undergraduate degree or equivalent experience

  • 3+ years of experience in credentialing or clinical operations, auditing, or NCQA accreditation

  • Proficient computer skills - Microsoft Windows, Word, Outlook, PowerPoint, and Adobe PDF

  • Intermediate+ level proficiency with Excel

  • Must have a designated workspace and access to install secure high-speed internet via cable/DSL in home



Preferred Qualifications:




  • 2+ years of business writing experience

  • Excellent written and verbal communication skills including the ability to present information to large audiences

  • Assess and interpret customer needs and requirements

  • Identify solutions to non-standard requests and problems

  • Extremely detail orientated with focus on quality/quality assurance

  • Ability to navigate and assess provider records in UHC proprietary systems

  • Ability to work in ever changing, fast- paced environment while maintaining a flexible approach to managing tasks

  • Ability to use constructive criticism/feedback to improve skills and work processes

  • Ability to independently problem solve and apply critical thinking strategies

  • Ability to manage competing demands on time

  • Ability to respond quickly to new instructions, situations, methods, and procedures





To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment



Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 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.(sm)



Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $26.15 to $46.63. The hourly range for Connecticut / Nevada residents is $28.85 to $51.30. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.



*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.





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.

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