[Hiring] Dental Clinical Quality Patient Safety Specialist @UnitedHealth Group

Role Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

This position works under the direction of the Manager of Dental Operations. The individual in this role will focus on investigating dental potential quality issues, patient safety events, and sentinel/serious reportable events and utilization issues by conducting retrospective chart and focused reviews.

Schedule:

• Four 9-hour shifts and one 4-hour shift
• Monday - Thursday, 7:00 a.m. - 5:00 p.m. and Friday, 7:00 a.m. - 11:00 a.m. CST
• Flexibility to work remotely from anywhere within the U.S.

Primary Responsibilities:

• Identifies and reviews medical surgical potential quality issues (PQIs), patient safety issues, sentinel events (SEs), and serious reportable events (SREs) by applying best practice standards of care and clinical experience.
• Conducts timely reviews of electronic medical records to meet Optum standards.
• Investigations include research, analysis, and preparation of written and verbal case summaries with recommendations for further actions as necessary.
• Conducts detailed root cause analysis (RCA) for sentinel events (SEs) and serious reportable events (SREs).
• Ability to organize and maintain current investigation information about cases through documentation in quality of care and quality of service databases.
• Communicate in writing to health care providers, track timelines, and perform follow-up as appropriate.
• Develops peer review cases and other quality improvement activities identified by deviations from accepted standards of care and monitors corrective action plans to completion.
• Assists with quality studies and focused reviews by abstracting medical records for specified criteria.
• Participates on quality committees and presents cases to peer review quality management committee.
• Collaborate with Dental Director on complex care identified in PQIs / SEs / SREs as needed.
• Read, interpret, and document standards/requirements and/or technical specifications.
• Work with stakeholders for review/approval of results.
• Actively participate in meetings.
• Train others on relevant policies, rules, and regulations.
• Serve as a resource providing explanation and expertise.
• Maintains confidentiality of all activities.
• Performs other duties as assigned.

Qualifications

• Dental Hygiene Degree or Dental Assistant Diploma and/or applicable military experience.
• 3+ years of clinical dental experience.
• Proven ability to investigate, analyze, synthesize, and formulate conclusions.
• Proven ability to organize quality data in appropriate reporting format.

Requirements

• Quality experience within a managed care company.
• General knowledge of Medicare, VA, TRICARE, or other government health care programs.
• Solid computer skills with emphasis on Microsoft Office software.
• Proven excellent interpersonal, communication, and writing skills.
• Proven to be detail oriented and highly organized with effective time management skills.
• Proven ability to work in a fast-paced, dynamic environment.
• Proven ability to work in a rapidly changing environment; being adaptable and flexible.
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).
• Hourly pay for this role will range from $29 - $52 per hour based on full-time employment.

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.