UnitedHealthcare Community & State, part of the UnitedHealth Group family of companies, is looking for an experienced Compliance Officer to join our dynamic Compliance team. Things are exciting at UHG as we are experiencing unprecedented growth, and looking for someone for a leadership position on our team in Wauwatosa, WI. The Compliance Officer is an individual contributor role responsible for supporting all aspects of the compliance program for our Wisconsin Medicaid Health plan. This position reports directly to the Regional Director of Compliance and indirectly to Plan Leadership, and serves as a first point of contact for state regulators on compliance matters related to the plan. Provides leadership to and is accountable for the performance and results through multiple layers of management and senior level professional staff. The Compliance Officer will monitor changes to laws and regulations to ensure compliance with State & Federal laws, regulations and mandates. This individual will develop, implement and maintain the compliance program within UnitedHealthcare Community & State in order to ensure that we are meeting company guidelines and CMS requirements. They will establish and implement standard policies, procedures, processes and best practices across UnitedHealth Group to promote compliance with applicable laws and contractual obligations. The Compliance Officer will conduct state-specific research and monitor changes to requirements to mitigate risks and achieve compliance. Will also support the collection of data for regulatory filings, coordinate and develop reports, projects, and assessment tools to verify compliance. They will develop compliance communications and drive problem resolution for a business. Ideal candidates will have experience in a Wisconsin Medicaid regulatory or compliance role (from either a health insurance company or from government), will have experience working with state level regulators, will have experience working with OIGs, and will have strong project management experience and experience working in a matrixed environment. Primary Responsibilities:Develop and manage site Compliance Committee meetings Ensure written standards and procedures Provide training, communications and education Ensure proper reporting and response to state stakeholder Conduct auditing and monitoring, to ensure compliance Oversee contract compliance activities and vendor oversight Remain vigilant regarding fraud, waste and abuse Ensure privacy requirements are met within the health plan
Required Qualifications:Bachelor's degree or equivalent experience3+ years of experience in a role directly managing a compliance programExperience leading audits and major program initiativeAbility to identify root cause issues and ensure appropriate corrective actionExperience managing multiple projects/tasks; proven history of successful results in managing issues and driving strategic program initiativesProven ability to think strategically and to translate strategic directives into tactical initiativeProven ability to drive cross-functional teams to deliver operational complianceSuperior analytical, organizational and problem solving skillsMust live within commutable distance of the location listed for this specific career opportunityPreferred Qualifications:Experience working as a Subject Matter Expert in a large, highly-matrixed organization, working with various business segment and/or stakeholders Experience developing relationships with regulatory agencies Experience in managed care and government programs Experience and understanding of HIPAA and state privacy laws Experience developing and presenting training programs Master's degree or JD degree Experience and knowledge working with Wisconsin Medicaid Experience and knowledge working with state level regulators Experience in a strategic role, ideally leading and implementing a comprehensive compliance programCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm) 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. Job Keywords: Kansas City, KS, Medicaid, Office-based, Compliance, Regulatory, HIPAA, Managed Care, Government Program
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.