- 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
- 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
- Ability to attend in person meetings at our Indianapolis office
- Professional certification (Certified in Healthcare Compliance - CHC or similar)
- Experience with managed care and/or government programs
- 5+ years of Healthcare industry or Healthcare related industry experience and government programs
- Experience in a strategic role, ideally leading and/or implementing a comprehensive compliance program
- Industry and government programs experience
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Community & State Health Plan Compliance Officer - Indiana - Indianapolis, United States - UnitedHealth Group
Description
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.
If you are located within the greater Indianapolis, IN area you will have the flexibility to work remotely* as you take on some tough challenges.
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.
Primary Responsibilities:
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:
Preferred Qualifications:
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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.
