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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Customer Services


United States

Postal Code:


Approximate Salary:

Not Specified

Position Type:

Full Time

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Quality Assurance - Intake / Call - Tampa, FL

UHG - Tampa, Florida

Posted: 09/4/2018

Energize your career with one of Healthcare’s fastest growing companies.  


You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.


This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.


Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

This position is responsible for all aspects of quality assurance within the Customer Service job family. Conducts audits and provides feedback to reduce errors and improve processes and performance.

Primary Responsibilities:
  • Analyze current customer service processes and identify gaps or defects to improve overall effectiveness
  • Define/recommend process improvements to meet current and future customer service needs/standards
  • Ensure that customer needs are being met by current processes (e.g., review recorded agent conversations, identify/communicate opportunities for improvement)
  • Ensure appropriate usage of available resources by agents to respond to callers (e.g., applicable scripts, Subject Matter Experts)
  • Work directly with agents/staff to improve overall performance (e.g., focus groups)
  • Define Quality guidelines/programs to address identified issues and emerging business needs (e.g., newly acquired companies)
  • Identify/anticipate future business needs based on changes in the internal and external environment, and provide recommendations to meet those needs
  • Perform Quality audits and analyze results to determine process improvement opportunities
  • Review/monitor results of appeals work and escalate as necessary (e.g., rebuttals)
  • -Demonstrate understanding of applicable Customer Service Quality requirements/ guidelines (e.g., escalation procedures, use of SMEs)
  • Adhere to established Quality processes, procedures, requirements and guidelines, and ensure adherence by all applicable
  • stakeholders
  • Demonstrate understanding of specific workgroup roles/responsibilities (e.g., Call Center, operational groups, Tier I/II/III)
  • Define policies and procedures for applicable Quality teams (e.g., randomization processes, auditor evaluation definitions,calibrations)
  • Define/document Quality standards (e.g., caller interactions, use of applicable call tracking tools, caller verification/authentication)to support applicable customer service processes and groups (e.g., CSA populations, lead teams, client teams)
  • Demonstrate and apply understanding of established Quality concepts and principles (e.g., Six Sigma)
  • Demonstrate knowledge of call-flow processes/procedures (e.g., established quality definitions, guidelines)
  • Utilize applicable systems/tools to maintain and document Quality metrics/outcomes (e.g., SharePoint, Qfinity, MyMetrics, IRIS, Rx Express)
  • Provide training/coaching on Quality processes/procedures, as applicable (e.g., on-boarding, refresher training)
  • Document call quality/efficiency/effectiveness, using applicable metrics and tools (e.g., ETE, ATA, production standards)
  • Review/analyze quality data/metrics/reports and define remediation/performance improvement opportunities
  • Identify and communicate call quality patterns/trends to applicable stakeholders (e.g., floor supervisors, managers, leadership,Training) in order to drive appropriate action and meet future business needs
  • Monitor audit reports/results and provide feedback as needed to drive/validate audit effectiveness

Required Qualifications:
  • High School Diploma / GED (or higher)
  • 2+ years of experience in a customer service position auditing calls
  • Ability to utilize Microsoft Office in a professional setting with an emphasis on Microsoft Excel (create and edit spreadsheets)
  • Ability to work an 8-hour shift between 7:30 am - 8:30 pm Monday through Friday (EST)
Preferred Qualifications:
  • Bachelor's Degree (or higher)
The government services support team at Optum has earned the trust of organizations that our entire country relies on; from the Department of Defense and Veteran?s Administration to the teams at Health & Human Services and the Centers for Medicare and Medicaid Services. We?re repaying that trust with hard work, new ideas and a commitment to finding better solutions every day. Join us and help create ways for our government services agencies to be more efficient and effective. This will be the next huge step in your life's best work.

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.

Keywords: customer service support, audits, escalated issues, intake specialist, audit templates, metrics, healthcare

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