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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:




Approximate Salary:

Not Specified

Position Type:

Full Time

RN HEDIS Quality Supervisor - Dallas, TX

UHG - Dallas, Texas

Posted: 11/19/2018

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)


The Quality Supervisor is responsible for coordinating and implementing the HEDIS and STAR’s data collection using non-standard supplemental submission processes. Works in collaboration with the Quality Improvement Manager to develop strategies for achieving a 5 STAR rating. This role assists with quality data tracking and report preparation for ensuring data entry team performance is efficient and effective in achieving performance goals. Will supervise a team of clinical and nonclinical staff who perform medical record review and process electronic data entry submissions. Provides direction and support to the Supplemental Data Entry team using routine communication to promote standard work processes, orchestrates collaboration of efforts and works to ensure accountability for time and productivity to meet daily quota expectations. This role works closely and collaboratively with functional areas of the health IT delivery system to achieve the goals and objectives of the Quality Improvement Program.


Primary Responsibilities:

  • Provides leadership, support and training updates for staff that perform medical record review and data entry processing submitted by providers for the capture quality measure performance
  • Collaborates with provider clinic staff and WellMed market staff to execute the proper submission of medical record requirements based on current HEDIS technical specifications
  • Collaborates with the Corporate Quality Educator in the development of training resources on STAR/HEDIS measures, to include the training resource needs specific to SDS Data Entry staff to support proper collection of STAR/HEDIS data
  • Participates in new hiring actions and on-boarding requirements for staff
  • Conduct and manages meetings and training for staff on HEDIS/STAR measures, HEDIS/STAR data collection software and supplemental data collection strategies. Updates resource training materials and work plans within assigned responsibilities
  • Work with internal enterprise teams on data submission and transmission issues
  • Implements, tracks and analyzes audits on individual staff to monitor accuracy and integrity of quality data capture as required
  • Monitor and analyze daily volume of electronic submissions for possible data deficit issues. Utilize internal system tracking tools for review and validation of data integrity
  • Attend and participate in all QI related meetings
  • Performs all other related duties as assigned

This position is based out of the Dallas office and is not a telecommute role.

Required Qualifications:

  • Unrestricted Nursing License; Registered Nurse
  • 1+ year experience in an ambulatory care setting
  • 1+ year prior HEDIS/STAR quality measure experience in a managed care setting
  • 1+ year of experience with data analysis
  • 1+ years supervisory experience
  • Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS
  • Experience using Microsoft office applications, including but not limited to databases, word processing, spreadsheets, and graphical displays

Preferred Qualifications:

  • Associate Degree in Nursing or Business or related field
  • 1+ years of process management experience
  • Healthcare quality improvement experience
  • Demonstrated effective organizational skills
  • Excellent attention to detail and accuracy, with basic Evaluative and Analytical skills
  • Strong writing, proofreading and grammar skills
  • Proven capability to work with people at all levels in an organization
  • Training and presentation skills with solid communication capabilities and practices, both oral and written
  • Strong teamwork, interpersonal, verbal, written, and administrative and customer service skills

Physical & Mental Requirements:

  • Ability to lift up to 25 pounds
  • Ability to sit for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)


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.



Job Keywords: HEDIS, Quality, RN, Supervisor, data mining, reporting, registered nurse, NCQA, Dallas, TX

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