Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team 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 make 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 Training/Quality Assurance Manager reports to the Director National RCM - East. This role ensures the accuracy, efficiency, and compliance of revenue cycle operations. They will develop, implement, and monitor training programs for staff involved in all backend revenue cycle processes to include AR, posting, correspondence, authorizations and patient call center operations. Additionally, the manager will establish and monitor quality assurance measures, assigned by the VP/Sr. Director to identify areas for improvement, reduce errors, and optimize revenue generation. Further, they will maintain a dotted-line oversight with offshore training and QA staff to ensure consistency and standardization of all training and QA program content, delivery and materials.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:

• Develop training program and certification for all revenue cycle departments under VP/Sr. Director to include offshore teams
• Develop and implement quality assurance programs and methodologies to monitor the accuracy and efficiency of revenue cycle processes
• Conduct regular audits and reviews of billing, coding, and collection activities to identify errors and discrepancies
• Analyze data and generating reports on key performance indicators (KPIs) to track quality and identify trends
• Collaborate with other departments to address quality issues and implement corrective actions
• Ensure compliance with all relevant regulations and industry standards, including HIPAA, Medicare, Medicaid, and payor guidelines
• Provide feedback and coaching to staff on performance and development areas
• Collaborate with leadership to ensure that revenue cycle goals are met
• Promote a culture of quality, compliance, and continuous improvement within the revenue cycle department
• Develop and implement necessary training based on trends identified in data analysis
• Ensure adherence to regulations, ethical standards, and best practices throughout the revenue cycle process

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:

• 5+ years in healthcare revenue cycle management
• 3+ years in a healthcare quality assurance or training role
• 3+ years in a leadership role
• Extensive Epic experience and certification

Preferred Qualifications:
Certifications: Certified Professional in Healthcare Quality (CPHQ), Manager of Quality/Organizational Excellence (CMQ/OE), Six Sigma Green and/or Black Belt, Certified Quality Auditor (CQA), Certified Quality Improvement Associate (CQIA), Certified in Healthcare Compliance (CHC), Healthcare Quality & Management (HCQM), Certified Professional in Healthcare Management (CPHM), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA)

• Project management experience

Soft Skills Required:

• Experience in the healthcare industry, particularly with provider networks, insurance, or healthcare regulations
• Experience in project management
• In dept knowledge of HIPPA Practices
• In depth knowledge of healthcare billing, coding, reimbursement, and medical terminology
• Solid understanding of healthcare compliance regulations
• Understand and utilize key revenue cycle metrics (KPIs)
• Proficiency with Microsoft Office (Excel, PowerPoint, Word)
• Proficiency with reporting tools and software
• Proven record of developing and implementing training and QA programs
• Proven leadership and team management skills
• Exceptional communication, interpersonal, presentation, and customer service skills
• Ability to work effectively in a fast-paced environment, while managing multiple priorities
• Ability to design, develop, and deliver training programs tailored to healthcare revenue cycle management
• Utilize data and analytics for informed decision-making
• Identify root causes of revenue cycle issues

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required