Quality Assurance Coordinator, UnitedHealth Group

The Quality Assurance Coordinator drives the success of naviHealth Patient Navigation Solutions with the goal of leading collaboration to improve quality of care and experience for our naviHealth patients. The Quality Assurance Coordinator works on continuously evolving and growing the quality and performance improvement initiatives as naviHealth takes on new business. The Quality Coordinator is responsible for identifying and executing on areas of opportunity within the Patient Navigation operational model. This position will provide support to leadership and will play an important part in supporting and driving initiatives within the team. This position conducts analytical reviews of quality data and colleague functions through collection, observation, and analysis to build recommendations for training enhancements and quality improvement plans.

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

Primary Responsibilities:

• Collect, review, and summarize quality data, perform adequate data analyses, and supply reporting to identify areas of improvement on an ongoing basis for all Patient Navigation programs
• Collaborate with leadership team to define quality measures to ensure baseline standards are established
• Monitor and analyze outcomes to ensure goals and objectives, are met
• Design and produce sampling procedures as needed
• Report deficiencies and findings to department leaders and management affecting success with suggested actions; make recommendations and establish timetables for corrections and provide improvement suggestions to Training & Development and/or HR
• Participate in the development and testing of PILOT
• Provide training and SOP’s for new rollouts of system enhancements
• Make recommendations for new features and improvements for increased service delivery
• Detect and report software failures identified through quality monitoring
• Partner with department leaders to resolve major quality programs
• Anticipate operational challenges and ensure preventative actions are taken to reduce errors before they happen
• Contribute to rollouts of company or department initiatives to improve service delivery and/or quality
• Monitor progress and functionality of new rollout processes and procedures and report findings to leadership
• Participate in all new implementations in order to fully understand the new service offerings so that quality assurance measures can be put in place post implementation to ensure we are meeting contract requirements
• Review, audit, and close internal cases as well as prepare external summaries for reporting purposes

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:

• High school diploma or equivalent required
• Minimum of 2 years of experience gathering requirements and analyzing data and/or in quality improvement

Preferred Qualifications:

• 1+ years managing patient care
• General knowledge of insurance benefits structures
• Strong working knowledge of medical terminology and healthcare landscape
• Must be able to qualify and maintain HIPAA requirements
• General working knowledge of medical terminology and healthcare landscape
• Proficiency in Microsoft Office (Word, Excel, and Outlook) and data entry skills

Soft Skills:

• Excellent written and verbal communication skills, ability to act independently with minimum supervision, attention to detail, and ability to meet deadlines
• Strong analytical and problem-solving skills
• Excellent written and verbal communication skills
• Ability to act independently with minimal supervision
• Ability to support and interact with colleagues providing supervision
• Strong organizational and multi-tasking skills needed
• Excellent problem solving and critical thinking

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