Senior Regulatory Adherence Analyst

UnitedHealth Group • Minnetonka, MN

1d • $72,800 - $130,000 • Remote

About The Position

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.

Requirements

• 3+ years of experience in a legal, regulatory or compliance role in healthcare or managed care
• 3+ years of experience working in government, healthcare, managed care, or health insurance environment
• 3+ years of experience in PBM or health plan
• 3+ years of Medicaid or Medicare audit experience
• 3+ years of experience developing and leading a consistent audit process to ensure all outside audits are effectively managed
• 3+ years of experience monitoring changes to laws and regulations to ensure compliance with State & Federal laws, regulations, and mandates
• 3+ years of experience developing reports for leadership and cross functional teams to communicate current audit statuses, trends, and areas of opportunity
• 3+ years of experience managing multiple projects and competing deadlines
• Ability to travel up to 10%25 as needed

Nice To Haves

• Working knowledge in coverage determinations and exceptions
• Proficiency using MS Word, MS Excel, and MS PowerPoint
• Ability to communicate clearly and professionally in both oral and written communication
• Demonstrated ability to communicate effectively in written & verbal English
• Demonstrated ability to stay organized and practice effective time management skills
• Demonstrated ability to work effectively and congenially with employees at all levels

Responsibilities

• Consistently evaluate and re-evaluate current procedures to ensure best-in-class practices are implemented
• Lead cross-functional training to internal business partners
• Working directly with internal business partners, clients, government auditors
• Developing reports for leadership and cross functional teams to communicate current audit statuses, trends, and areas of opportunity
• Developing and leading a consistent audit process to ensure all outside audits are effectively managed
• Solves problems and develops innovative solutions
• Monitor audit progress and resolve potential findings as appropriate
• Monitor changes to laws and regulations to ensure compliance with State & Federal laws, regulations, and mandates
• Analyzing the root cause of issues and aiding in development of appropriate action plans
• Follow standard policies, procedures, and best practices across Optum Rx/UHG to promote compliance with applicable laws and contractual obligations
• Assisting in or leading various special audits/projects as directed by the Director of Government Programs
• Audit Support Travel as required (up to 10%25)

Benefits

• 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.)

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed