4 days old

Clinical Quality Auditor - Telecommute

Eden Prairie, MN 55344 Work Remotely
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Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)


The Clinical Quality Auditor completes independent audits and provides feedback to reduce errors and improve processes and performance. Within the job scope, ensures adherence to accreditation standards and requirements, departmental and regulatory data integrity standards and requirements, and contractual obligations with State and Federal agencies. This position works under the supervision of the VA Nurse Advice Line (NAL) Clinical Audit Supervisor.


You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • Conduct various audits for the VA NAL program to include E2E nurse call documentation and phone interaction and etiquette  
  • Evaluate competency of clinical assessment performed, follow on care coordination provided and documentation of medical care delivered
  • Based on review of clinical data/documentation, identify potential quality of care issues (e.g., variations from standard practice potentially resulting in adverse outcomes) and potential fraud/waste/abuse
  • 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 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, Verint, MSI)
  • Actively participate in meetings
  • Other duties as assigned

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.

Posted: 2020-10-15 Expires: 2020-11-15

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Clinical Quality Auditor - Telecommute

UnitedHealth Group
Eden Prairie, MN 55344

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