UnitedHealthcare is a company that’s on the rise. We’re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn’t about another gadget, it’s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life’s best work.(sm)
This position has responsibilities as the local market health plan compliance officer and is an individual contributor.
Primary Responsibilities:
- Be able to manage a compliance program with an understanding of complex or dual products
- Engages in high risk/complex remediation strategy & resolution and promote compliance with applicable laws and contractual obligations for various Medicaid products
- Collaborate with a team that conducts product-specific legal research and monitors changes to requirements to mitigate risks and achieve compliance
- Interpret complex, technical, professional, regulatory or legal information and publications distilling into actions as needed
- Collaborate with other legal, regulatory affairs, and compliance professionals cross-functionally to ensure regulatory and contractual requirements are met
- Investigate identified compliance matters, including corrective action and mitigation
This role requires a unique ability to develop relationships, analyze information and influence multiple stakeholders to increase engagement and get the needed results. You will be working in a matrixed environment with multiple groups while ensuring that resources are used effectively to mitigate risks and achieve compliance.
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:
- Bachelor’s degree or equivalent work experience
- 3+ years of experience in a role directly managing key aspects of a compliance program
- 3+ years of experience working in a government, legal, healthcare, managed care and/or health insurance environment in a regulatory, privacy or compliance role
- Experience managing teams, major program initiatives or working with regulatory agencies
- Broad knowledge and experience in: Ability to navigate and influence a complex matrixed environment across UHC, Optum and other delegated entities and drive to resolution
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifcations:
- Advanced Degree (JD or Master’s)
- Professional certification (Certified in Healthcare Compliance – CHC or similar)
- 5+ years of Healthcare industry or Healthcare related industry experience and government programs
- Experience with managed care and/or government programs
- Experience in a strategic role, ideally leading and/or implementing a comprehensive compliance program
- Solid skills in: goal(s) setting and works independently to achieve them. Pushes self and others to reach milestones
- Excellent skills in: verbal and written communication; problem solving
- Demonstrates advanced writing/presentation skills. Easily shifts style based on audience
- Demonstrated ability to: make decisions even when information is limited or unclear
- Demonstrated ability to: Adept at understanding and resolving complex concepts and situations presented by the business environment; ability to assess complex problems and recommend the appropriate compliance solutions
- Other: Ability to effectively deal with ambiguity – can effectively cope with change, can shift gears comfortably, can decide and act without having the total picture, comfortably handles risk and uncertainty in a manner consistent with UnitedHealth Groups core values, culture and common language of leadership
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with UnitedHealthcare. Let’s talk about opportunity. Start with a Fortune 5 organization that’s serving more than 85 million people already and building the industry’s singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they’re found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none. This is no small opportunity. It’s where you can do your life’s best work.(sm)