Account Manager - QOI Operational Strategy and Oversight - Remote in US

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Account Manager Position on the QOI Operational Strategy and Oversight team is aligned to Government Programs and implements strategy and drives performance during HEDIS Medical Record Review. This position is customer centric and is accountable for meeting the expectations of, as well as maintaining positive and productive relationship with, leadership, internal business partners, and external vendors. Direct oversight of management of staff or contractors is required.

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

Primary Responsibilities:

• Oversee internal and external partners for medical record collection performance, project planning, timeline progress, issues, and risks
• Identification and development of quality improvements, strategic planning, collaboration internal and external business partners
• Builds and maintains relationships with vendors, customers, business partners, consultants, providers to meet/exceed business objectives and issue resolution
• Work collaboratively, and in partnership with a broad spectrum of business partners to ensure flawless execution of business goals
• Form effective relationships with stakeholders by providing timely responses, partnering on issue resolution/mitigation strategies, and monitors resolution of identified issues to conclusion
• Drives work independently, determines next steps, highlights risk and barriers, and develops mitigation plan without extensive oversight
• Use reporting tools and dashboards, report out and highlight operational performance deviations
• Hiring and management of temporary staff
• Reviews assigned medical records to verify clinical data elements for HEDIS reporting, e.g., results of laboratory tests, verification of hypertension and the most recent blood pressure reading, prenatal and postpartum care services
• Identifies findings supported by documentation guidelines with high level of accuracy
• Conducts claims research, determining correct service location or verifying member history
• Other responsibilities as assigned

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:

• 5+ years direct HEDIS and / or medical record review experience
• 5+ years Healthcare industry or managed care experience
• 3+ years of experience monitoring and analyzing Medicaid HEDIS Retrospective projects
• 3+ years accessing and retrieving medical records via remote access
• Experience working within a large multinational matrixed environment
• Significant operations metric analytics and reporting experience
• Proven experience in monitoring and analyzing performance KPI's and SLAs
• Intermediate level of proficiency with Microsoft Office applications, including: Word, Excel and PowerPoint
• Proven excellent time management skills with ability to prioritize and balance multiple priorities and projects
• Proven excellent stakeholder management skills and a demonstrated ability to communicate ideas clearly and concisely to leadership
• Proven solid communication skill sets, with the ability to support and present information in a variety of different formats to all levels of stakeholders

Preferred Qualifications:

• Clinical and/or Health Education experience (RN or LPN desired)
• Experience working with HEDIS software vendors (management, building relationships, issue resolution etc.)
• Experience managing projects in an IT, production, or operational type department
• Experience with data analytics

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

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. 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.

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.

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.