Regulatory Adherence Analyst
Optum 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Serving as primary lead on audits performed by our clients and regulatory / government agencies
Working with internal business partners and government auditors
Serve as a resource for team members
Determine the appropriate scope, timing and logistics of the audits
Prepare audit requests for documentation or data universes as required
Developing a consistent audit process to ensure all outside audits are effectively managed
Analyzing the root cause of issues and aiding in development of appropriate action plans
Actively engaged in process improvement projects
Providing reporting to management
Providing updated statuses on audits assigned
Creating audit documentation
Creating and giving internal and external presentations
Assisting in or leading various special projects as directed by the Manager of Government Programs Audit Support
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 in PBM or health plan
2+ years of experience in a legal, regulatory or compliance role in healthcare or managed care
2+ years of experience working in a government, healthcare, managed care, or health insurance environment
1+ years of Medicaid or Medicare audit experience
Ability to travel up to 10%25 as needed
Preferred Qualifications:
Working knowledge in coverage determinations and exceptions
Intermediate level of proficiency using MS Word, MS Excel, and MS PowerPoint
Experience managing multiple projects and competing deadlines
Ability to communicate clearly and professionally in both oral and written communication
Demonstrated ability to communicate effectively in written & verbal English
Demonstrated ability to manage multiple projects
Demonstrated ability to stay organized and practice effective time management skills
Demonstrated ability to work effectively and congenially with employees at all levels
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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 salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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 the volume of applicants.
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.
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.
#RPO #GREEN
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Serving as primary lead on audits performed by our clients and regulatory / government agencies
Working with internal business partners and government auditors
Serve as a resource for team members
Determine the appropriate scope, timing and logistics of the audits
Prepare audit requests for documentation or data universes as required
Developing a consistent audit process to ensure all outside audits are effectively managed
Analyzing the root cause of issues and aiding in development of appropriate action plans
Actively engaged in process improvement projects
Providing reporting to management
Providing updated statuses on audits assigned
Creating audit documentation
Creating and giving internal and external presentations
Assisting in or leading various special projects as directed by the Manager of Government Programs Audit Support
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 in PBM or health plan
2+ years of experience in a legal, regulatory or compliance role in healthcare or managed care
2+ years of experience working in a government, healthcare, managed care, or health insurance environment
1+ years of Medicaid or Medicare audit experience
Ability to travel up to 10%25 as needed
Preferred Qualifications:
Working knowledge in coverage determinations and exceptions
Intermediate level of proficiency using MS Word, MS Excel, and MS PowerPoint
Experience managing multiple projects and competing deadlines
Ability to communicate clearly and professionally in both oral and written communication
Demonstrated ability to communicate effectively in written & verbal English
Demonstrated ability to manage multiple projects
Demonstrated ability to stay organized and practice effective time management skills
Demonstrated ability to work effectively and congenially with employees at all levels
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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 salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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 the volume of applicants.
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.
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.
#RPO #GREEN