Risk Quality Management Associate - Hybrid

Posted 2 Hours Ago
Be an Early Applicant
Worcester, MA, USA
Hybrid
20-36 Hourly
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Provide day-to-day risk management and patient safety support across Optum Massachusetts sites: manage safety event reporting (RLDatix), aggregate and analyze claims and incident data, maintain peer review and claims files, prepare correspondence and reports, support managers with administrative projects, and assist with patient communications and regulatory compliance.
Summary Generated by Built In
Requisition Number: 2374037
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 to start Caring. Connecting. Growing together.
Under the direction of the Senior Manager, Risk Management, Optum Massachusetts, the Risk & Quality Management Associate provides day-to-day risk management and patient safety support across all Optum Massachusetts sites. Performs a variety of duties related to data input, analysis, trending and tracking of claims and risk management information. Performs a variety of duties involving multiple high-level administrative projects. Assist managers or others in administrative functions. Has frequent contact with the public and high-level staff personnel on matters requiring tact and knowledge of department policies and procedures.
Location: 385 Grove Street, Worcester, MA
Hours: Monday - Friday between 8am & 5pm.
If you are located in Worcester, MA, you will follow a hybrid schedule with two in-office days per week.
Primary Responsibilities:
  • Establish and lead an atmosphere of Just Culture
  • Actively promotes and utilizes the safety event reporting system (RLDatix) for adverse events, including near misses, occurring at all Optum Massachusetts sites
  • Conducts data aggregation and analyses to assess performance improvement opportunities and measure improvements
  • Reviews insurance carrier information and reports to outside healthcare entities requesting malpractice insurance coverage verifications
  • Assists with developing warning and termination letters for patients as directed
  • Collects, evaluates and distributes relevant data concerning patient injuries; aggregate data summaries, monthly/quarterly trends; provides aggregate analysis of risk data and trending of losses, etc.
  • Assist in the maintenance of Peer Review files consisting of claims, suits, PCEs, and patient complaints for each practitioner
  • Performs various administrative functions for managers or others to relieve him/her of responsibility and detail
  • Prepares and submits requisitions for supplies, equipment or maintenance service with appropriate signatures
  • Prepares and distributes notices of correspondence to all Managers, Supervisors, Directors and Physician Leadership
  • Prepares, copies and maintains records of correspondence, takes telephone messages, schedules appointments and meetings, supplies routine answers where possible, and places outgoing telephone calls
  • Engages in extensive contact with all levels of personnel in a professional and confidential manner. Promptly and courteously receives all visitors to the department
  • Maintains files and records usually of a highly confidential nature
  • Prepares minutes of meetings, memos, and letters as required
  • Works within established policy, precedent and guidelines. Work is broad, varied and complex
  • Involves ownership of ongoing projects or one-of-a-kind tasks. Requires multi-tasking. Will need to be resourceful and track down information to find answers or solve problems and make decisions. Expected to create efficiencies and streamline processes as required
  • Establishes own work plan and prioritizes, using and/or modifying established procedures, to ensure timely completion of assigned work in conformance with established departmental policies and standards; problems lacking clear precedent are usually reviewed with supervisor prior to taking action
  • Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
  • Complies with established departmental policies, procedures, and objectives
  • Enhance professional growth and development through educational programs, seminars, etc.
  • Attends a variety of meetings, conferences, and seminars as required or directed
  • Performs other similar and related duties as required or directed
  • Regular, reliable and predicable attendance is required

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:
  • 3+ years of secretarial/administrative support experience, preferably in a Healthcare setting
  • Experience and expertise in public speaking
  • Working knowledge of graphics
  • Ability to work on Site at 385 Grove Street, Worcester, MA at least twice per week
  • Solid automated spreadsheet skills (ability to set-up worksheets and formal data)
  • Advanced word processing skills (ability to enter and manipulate complex, difficult and non-routine text or numerical date)
  • Demonstrated ability to review and synthesize data and present data and strategy to a large group of diverse individuals
  • Demonstrated ability to prepare spreadsheets including financial data and be able to determine when it is appropriate to use Excel, PowerPoint or Word
  • Driver's License and access to reliable transportation

Preferred Qualification:
  • Background in healthcare

Working Conditions / Physical Demands:
  • Busy office environment with frequent deadlines and interruptions
  • Regional travel between medical groups
  • Must be able to regularly travel to multiple locations which may or may not be accessible by public transportation
  • Occasional early or late meetings to accommodate clinician's schedules
  • Physical health is sufficient to meet the ergonomic standards and demands of the position

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 hourly pay for this role will range from $20 - $36 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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.
OptumCare 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
#BI-Hybrid

Skills Required

  • 3+ years of secretarial/administrative support experience, preferably in a Healthcare setting
  • Experience and expertise in public speaking
  • Working knowledge of graphics
  • Ability to work on Site at 385 Grove Street, Worcester, MA at least twice per week
  • Solid automated spreadsheet skills (ability to set-up worksheets and formal data)
  • Advanced word processing skills (ability to enter and manipulate complex, difficult and non-routine text or numerical data)
  • Demonstrated ability to review and synthesize data and present data and strategy to a large group of diverse individuals
  • Demonstrated ability to prepare spreadsheets including financial data and determine when to use Excel, PowerPoint or Word
  • Driver's License and access to reliable transportation
  • Background in healthcare
  • Pass a drug test before beginning employment

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Healthcare Strength Official materials highlight copay and HSA medical plan choices with in‑network preventive care at 100%, prescription coverage, and low/no‑cost virtual visits, plus company HSA contributions. Dental preventive services are 100% in network, and mental health resources include an EAP and premium Calm access.
  • Parental & Family Support Programs include six weeks paid parental leave, up to two weeks paid caregiver leave, and Bright Horizons back‑up care with enhanced family supports. Adoption assistance up to $10,000 for full‑time employees reinforces family‑oriented benefits.
  • Equity Value & Accessibility Financial benefits include an Employee Stock Purchase Plan at a 10% discount, expanding access to equity ownership.

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
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Bengaluru, India
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Dallas, TX
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Hyderabad, India
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Madison, WI
Minneapolis, MN
Nashville, TN
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Philadelphia, PA
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Raleigh, NC
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Washington, DC
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