Regulatory Affairs Consultant - Remote

UnitedHealth Group•Hartford, CT

1d•$91,700 - $163,700•Remote

About The Position

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Regulatory Affairs Consultant is responsible for monitoring, analyzing, and interpreting federal and state healthcare reimbursement regulations to ensure compliance across assigned products and services. This role interprets complex and evolving regulatory guidance, conducts impact assessments, and converts regulatory requirements into actionable business rules used to develop product specifications and operational workflows that ensure compliance and accurate implementation. Working closely with Product Managers, Business Analysts, and technical teams, the consultant supports the implementation of regulatory changes within the EASYGroup™ Prospective Payment System (PPS) product suite and contributes to ongoing product enhancements aligned with reimbursement trends and industry developments. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

3+ years of experience in healthcare reimbursement, regulatory analysis, healthcare policy, or a related discipline
2+ years of experience with Medicare, Medicaid, and other healthcare reimbursement methodologies
2+ years of experience with analytics, research, and problem-solving

Nice To Haves

Experience interpreting regulatory guidance and translating requirements into operational or technical solutions
Ability to manage multiple priorities and work independently in a dynamic environment
Excellent written and verbal communication skills with the ability to convey complex information to technical and non-technical audiences
PPS methodologies, CMS regulations, state Medicaid programs, healthcare software products, Salesforce, and the EASYGroup™ product suite

Responsibilities

Monitor and analyze federal and state regulatory updates impacting healthcare reimbursement
Interpret complex regulatory requirements and assess impacts to products, services, and client solutions
Research and resolve unclear, conflicting, or evolving regulatory guidance
Translate regulatory requirements into business rules that will be used to create operational workflows, and product specifications
Develop regulatory summaries, impact analyses, and implementation recommendations
Serve as a Subject Matter Expert (SME) for assigned areas of the EASYGroup™ PPS software suite
Support regulatory updates, product enhancements, and software releases to maintain compliance
Perform User Acceptance Testing (UAT), develop test scenarios, and validate functionality and regulatory compliance
Maintain regulatory content within internal systems, databases, and client-facing platforms
Manage and update tools utilized for regulatory monitoring and data collection
Respond to client inquiries through Salesforce, email, meetings, and other communication channels
Communicate regulatory and product updates through written documentation, webinars, and client discussions
Collaborate with cross-functional teams to ensure timely resolution of client and product-related questions
Research Medicare, Medicaid, TRICARE, commercial payer reimbursement methodologies, and emerging payment models
Evaluate state-specific reimbursement systems, healthcare trends, and market opportunities
Identify and implement process improvements to enhance efficiency, accuracy, and the overall client experience