QOC Nurse Supervisor - Remote

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.

This role supports Quality/Patient Safety efforts for the organization. Specifically, this position is responsible for managing front line non-clinical and clinical staff related to businesses process supported by the department. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Excellent working knowledge of systems used for processing of QOC cases QCare and OCM applications Microsoft applications (Outlook, Excel, Word, Teams) Adobe Acrobat Demographic systems (such as Facets, MACESS, UNET/COSMOS, NDB, etc.) Auto correspondence application Plans, prioritizes, organizes and completes work to meet established objectives Able to effectively utilize UHG applications related to QOC case research, including but not limited to written or verbal grievance documents, authorization applications, auto correspondence, and member & provider demographic systems Excellent verbal & written communication skills with internal & external customers Interface with other departments as needed (i.e. UHN, A & G, Case Management, Risk Management/Legal.) Attend monthly Regional Peer Review Committee meetings Manage team huddles and oversee team case inventory and adjust caseloads as needed Manage role specific meetings to discuss topics to educate and/or improve processes Coordinates work activities with other supervisors/managers Responsible for updating department Standard Operating Procedures (SOPs) and job aids Monitor performance through multiple reports, including but not limited to the following: Day Counts cases received monthly to assess for data entry errors and delayed cases Triage Closed Records monthly to assess for inappropriate case volume Triage Analyst Productivity document to assess productivity Triage Queue monthly to assess for incoming referral volume and assure timeliness on responses Run Open Case report weekly and assess QOC cases > 60 days old for potential barriers to timely case closure; review outliers with case owners and assist as needed Run Cases Received report weekly to evaluate for case data accuracy and completeness Run Closed Cases report weekly to evaluate for case data accuracy and completeness Prepare Key Performance Indicator (KPI) report monthly for NVP and identify root cause for outliers for TAT and fluctuations in case volume experienced Collaborate with QOC managers for internal committee reporting Collaborate with QOC managers for external regulatory agency reporting Monitor staff attendance and evaluate PTO requests for approval based on business needs Manage staff performance issues through coaching and corrective action plan process as needed Evaluate staff performance throughout the year and during MAP/ YIR (year in review) Special projects as assigned by QOC manager, director or NVP