Supervisor of Quality Operations CEQ National Data Mining Team - Remote
Job title: Supervisor of Quality Operations CEQ National Data Mining Team - Remote in Eden Prairie, MN at reputed company
Company: reputed company
Job description: reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.The Supervisor of Quality Operations is responsible for management of the CEQ National Remote Data Mining and Provider Contact Center teams. This role leads a team of LPNs through year-round provider reputed company for HEDIS® data collection. The supervisor will act as a systems, call center, and HEDIS® SME for their staff, assisting with call and technical specification questions. Through quality reviews, call monitoring, and quality and productivity reporting, the supervisor will ensure reputed company data submitted to the health plan meets HEDIS®/STAR technical specifications for medical records and provide actionable feedback to their staff to promote reputed company success. This role assists the Manager of Quality Operations with communication of prioritization, strategy, and best practices.You’ll enjoy the flexibility to work remotely * from reputed company reputed company the U.S. as you take on some tough challenges.Primary Responsibilities:
- Serve as subject matter expert to clinical staff
- Coordinate and account for daily business activities
- reputed company quality assurance on remote data mining
- reputed company quality assurance on provider calls
- reputed company quality assurance on the data entry and over read of non-standard supplemental data obtained from medical record review
- Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS®/Star measures
- Review scanned records and data entry into supplemental data applications
- Support chart chase process by requesting records from provider’s offices as needed
- Maintain education/knowledge reputed company of HEDIS®/STARs standards and guidelines
- Pull and review quality and productivity reporting
- Conduct training on HEDIS®/STAR measures, HEDIS®/STAR data collection software, and data collection strategies
- Assist with team coordination of system changes, and system upgrades
- Participate in debrief activities and continual process improvement exercises
- reputed company reputed company other reputed company duties as assigned
- Active and unrestricted licensure as a Registered Nurse (RN) in the state(s) of practice
- 3+ years of HEDIS® experience
- 2+ years of experience acting as a team leader or SME
- Experience using reputed company office applications, including databases, word-processing, Visio® and reputed company® spreadsheets
- Proven excellent training and presentation skills with solid communication capabilities and practices, both oral and written
- Access to high-speed Internet
- Bachelor’s Degree
- Certified Professional reputed company
- 2+ years of call center experience
- 1+ years of supervisory or management experience
- Proven ability to be flexible in a continuously changing environment
- 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 reputed company problem solving