UnitedHealth Group

C&S Health Plan Compliance Officer - Greensboro, North Carolina

Posted on: 6 Feb 2021

Greensboro, NC

Job Description

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:

* Ability 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 will allow flexibility to telecommute during COVID, but will return to office post COVID***

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
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

* Advanced Degree (JD or Master's)
* Experience with managed care and/or government programs
* Experience in a strategic role, ideally leading and/or implementing a comprehensive compliance program
* Professional certification (Certified in Healthcare Compliance - CHC or similar)
* 5+ years of Healthcare industry or Healthcare related industry experience and government programs.
* Ability to navigate and influence a complex matrixed environment across UHC, Optum and other delegated entities and drive to resolution
* Strong 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 be 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
* 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

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 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)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: C&S Health Plan Compliance Officer, Government, Legal, Healthcare, Managed Care, Health Insurance, Health Care, Regulatory, Privacy, Compliance, Regulation, Certified In Healthcare Compliance, CHC, Community & State, Baton Rouge, LA, Louisiana, UHG, UnitedHealth Group, UHC, UnitedHealthcare

UnitedHealth Group

Hopkins, MN

UnitedHealth Group Incorporated operates as a diversified health care company in the United States. It operates through four segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. The UnitedHealthcare segment offers consumer-oriented health benefit plans and services for national employers, public sector employers, mid-sized employers, small businesses, and individuals; health and well-being services to individuals age 50 and older, addressing their needs for preventive and acute health care services, as well as services dealing with chronic disease and other specialized issues for older individuals; and Medicaid plans, Children’s Health Insurance Program, and health care programs; and health and dental benefits.

The OptumHealth segment provides access to networks of care provider specialists, health management services, care delivery, consumer engagement, and financial services. This segment serves individuals through programs offered by employers, payers, government entities, and directly with the care delivery systems.

The OptumInsight segment offers software and information products, advisory consulting arrangements, and services outsourcing contracts to hospital systems, physicians, health plans, governments, life sciences companies, and other organizations. The OptumRx segment provides pharmacy care services and programs, including retail network contracting, home delivery, specialty and compounding pharmacy, and purchasing and clinical, as well as develops programs in areas, such as step therapy, formulary management, drug adherence, and disease/drug therapy management. UnitedHealth Group Incorporated was founded in 1974 and is based in Minnetonka, Minnesota.

Similar Jobs