Claims Quality Manager - Oldsmar, FL, Hartford, CT or New York, NY

Lead team of Transaction Service Analysts (TSA) in driving improvements in site level E2E quality activity using statistical tools and methods. Site Level Leader/Representative for external audit preparation and quality Performance Guarantee results. This role will have accountability for an expanded site scope (one major site, multiple smaller sites, and at least one global site relationship).

Primary Responsibilities:

• Lead Transaction Service Analysts (TSA) in identifying root cause errors and opportunities for defect reduction using statistical tools and methods
• Statistically analyze and develop overall improvement plans to ensure passing of external audits
• Translate analytical findings into an executable/actionable plan and drive results for the site/expanded sites
• Communicate trends and performance results to site leadership and executive management
• Partner with National Accounts leadership
• Share best practices to improve Transactions service delivery model
• Collaborate with associates and office leadership in developing individual and team improvement plans
• Initiate process improvement activities focused on quality improvement
• Strategic focus on all quality fronts
• Communicate to senior leadership, customers, and sales organization through e2e, connect call and audit remediation meetings
• Develop go-forward plans and remediation plans for audit activity using statistical methods and tools. Coordinate and execute audit activity including remediation calls, detailed action plans, and site communication
• Develop action plans for Connect and E2E call
• Review resource alignment and workload assigned by Transactions Service Analysts (TSA)
• Construct agenda and materials and facilitate weekly site quality partner call
• Provide final sign off on all audit checklist activity in partnership with local Site Director
• Understand and monitor external audit companies and their nuances, provide Transaction Service Analyst (TSA) team with appropriate plan for impacting account results
• Examine and report historical audit findings and PG misses to AMT and other internal customers
• Collaborate with business partners for escalated remediation for system and/or case issues related to external audits and/or PGs
• Report external audit and PG site actions to senior leadership during business review call
• Partner with National Account transactions management and other sites to support TSA best practices for audit preparation
• Provide site director account overview and talking points for audit/client meetings
• Attend client and audit remediation meetings as needed

• 3 years Supervisory experience
• MS Word, Excel and PowerPoint experience; Must know pivot tables, V-Look ups, charting and simple formulas. Will be required to create presentations from scratch as well as use templates in PowerPoint
• Knowledge of HR procedures 3 years
• HS diploma/GED
• Must be able to lead and develop a technical and tenured staff; strong leadership skills to motivate staff

Assets:

• Familiarity with Six Sigma preferred
• Bachelor's degree preferred

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.