UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Description
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling.
By providing 60 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their Behaviroal health care needs, and enabling them to achieve their personal health and well-being goals.
Positions in this function monitor changes to laws and regulations to ensure compliance with State & Federal laws, regulations and mandates. The individual will oversee preparation for state audits (and assist, at times), oversee contract compliance with new business implementation, amd develop Policies & Procedures for new Medicaid markets. Work through our clinical front end system regarding utilization, appeals and all contract compliance documentation.
Establish and implement standard policies, procedures, processes and best practices across Optum health Behavioral Solutions to promote compliance with applicable laws and contractual obligations.
Conduct state-specific legal research and monitor changes to requirements to mitigate risks and achieve compliance.
Support the collection of data for regulatory filings, coordinate and develop reports, projects, assessment tools to verify compliance.
May develop compliance communications and drive problem resolution for a business.
- Company thought leader.- Functional SME.- Broad business approach.- Resource to senior leadership.- Develops pioneering approaches to emerging industry trends.
At OptumHealth, you will perform within an innovative culture that's focused on
transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
Qualifications
- Bachelor's degree and five or more years ofCompliance experience in Public Health--particularly in a Medicare, Medicaid health plan environment.
- Demonstrated expertise in stsae audit preparation, new contract implementation and creating ploicies and procedures/vetting through the new regulations for Medicare and Medicaid state contracts.
Experience in a behavioral health setting is highly desirable.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
