UnitedHealth Group
Job Family Description:Positions in this family support claim processing functions including investigations, negotiating settlements, payments, research regarding eligibility, etc.Job Function Description:Positions in this function are responsible for all aspects of quality assurance within the Claims job family. Conducts audits and provides feedback to reduce errors and improve processes and performance.General Job Profile:- Analyzes and investigates.- Provides explanations and interpretations within area of expertise.Job Scope and Guidelines:- Uses pertinent data and facts to identify and solve a range of problems within area of expertise.- Investigates non-standard requests and problems, with some assistance from others.- Works exclusively within a specific knowledge area .- Prioritizes and organizes own work to meet deadlines.- Provides explanations and information to others on topics within area of expertise.
QMQI performs reviews based on established, documented processes. Provides feedback to area leadership on audit findings. Provide BPI suggestions to operational team and follow work instruction update process. Work on BPI teams with a lead or major role and or lead BPIs end to end. Respond to appeal and make corrections to audits. Provides feedback and or responses on audit results and corrective & preventative actions, based on identified defects.
Remote- Nationwide
No reviews yet. Reviews unlock for candidates 30 days after adding this program to their tracker — integrity over volume.
Interview prep for this program▸
- ▸ "How many of your past SkillBridge interns received full-time offers?" — a serious program knows the number.
- ▸ "Who will my day-to-day mentor be, and what does week one look like?"
- ▸ "How do virtual interns stay visible to hiring managers — what worked for past cohorts?"
- ✓ Your projected start window and separation date (from your profile)
- ✓ Your command's approval status — even "packet drafted" signals you're serious
- ✓ Your civilian-translated resume bullets (generate them here)
- ✓ A written training-plan ask — you'll need it for your packet anyway
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