3+ years of experience managing compliance programs or in a regulatory position, Experience in government, legal, healthcare, managed care, or health insurance environments, Demonstrated skills in communication, problem-solving, and decision-making, Ability to navigate complex environments and influence stakeholders effectively..
Key responsibilities:
Manage health plan compliance programs and engage in remediation strategies
Evaluate compliance functions and recommend improvements
Collaborate with legal and compliance teams to ensure regulatory requirements are met
Conduct research on state Medicaid requirements and address compliance issues.
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When it comes to your health, everything matters. That’s why UnitedHealthcare is helping people live healthier lives and making the health system work better for everyone. Our health plans are there for you in moments big and small, delivering a simple experience, affordable coverage, and supportive care. Wherever your health takes you, we're there for what matters.
At UnitedHealthcare, part of the UnitedHealth Group family of businesses, we are working to create a system that is connected, aligned and more affordable for all involved; one that delivers high quality care, responsive to the needs of each person and the communities in which they live. With connections to more than 1.3 million physicians and care professionals and 6,500 hospitals and care facilities across the globe, we can collaborate in new ways to improve patient care while providing customizable and comprehensive solutions in any marketplace, anywhere.
Our Values
Integrity: Honor commitments. Never compromise ethics.
Compassion: Walk in the shoes of the people we serve and those with whom we work.
Relationships: Build trust through collaboration.
Innovation: Invent the future. Learn from the past.
Performance: Demonstrate excellence in everything we do.
For more information about UnitedHealthcare, click here: https://www.uhc.com/
For information about careers at UnitedHealthcare, click here: https://www.workatuhc.com
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
This Compliance Director will serve in a role providing direct support to UnitedHealthcare Community & State (C&S) compliance program and health plan compliance priority functions as defined.
If you are local to Nashville, TN, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities
Ability to manage elements of a health plan compliance program with an understanding of state-based government health care programs and products
Engage in complex remediation strategy & resolution and promote compliance with applicable laws and contractual obligations for various Medicaid products
Ability to flex by working across different markets with varying needs and expectations, as well as across the broader national compliance teams and various compliance program focus areas as needed
Evaluate compliance program functions and offer recommendations for continuous improvement
Conduct product-specific research (in collaboration with other regulatory affairs and legal teams) to identify state Medicaid requirements
Partner with legal, compliance and program integrity professionals to support national and market program integrity activities and communications
Collaborate with other legal, regulatory affairs, and compliance professionals cross-functionally to ensure elements of the compliance program are executed and that regulatory and contractual requirements are met
Evaluate identified compliance issues, including corrective action and mitigation
This role requires an ability to develop relationships, analyze information, recommend process improvements 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
3+ years of experience managing aspects of a compliance program or working in a regulatory position
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
Demonstrated solid skills in: goal(s) setting and works independently to achieve them. Pushes self and others to reach milestones
Demonstrated excellent skills in: verbal and written communication; problem solving
Demonstrated advanced writing/presentation skills. Easily shifts style based on audience
Demonstrated ability to make decisions even when information is limited or unclear
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
Proven 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
Reside in TN, with the ability to attend periodic in-person Health Plan meetings at the Brentwood office, and attend multiple in-person meetings with our regulators
Preferred Qualifications
Professional certification (Certified in Healthcare Compliance - CHC or similar)
5+ years of Healthcare industry or Healthcare related industry and government programs experience
Experience with managed care and/or government programs
Experience in a strategic role, ideally leading and/or implementing a comprehensive compliance program
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The salary range for this role is $106,800 to $194,200 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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.
UnitedHealth Group 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.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment
Required profile
Experience
Spoken language(s):
English
Check out the description to know which languages are mandatory.