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 Southfield, MI. The Compliance Officer is an individual contributor role responsible for supporting all aspects of the compliance 7 elements program for our Michigan Medicaid Health plan. This position reports directly to the Regional Director of Compliance and indirectly to Health Plan CEO, 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 Michigan 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.
Strategic Partner for the Michigan Executive Leadership team.
Develop and manage site Compliance Committee meetings
Ensure written standards and procedures
Provide training, communications and education
Ensure proper reporting and response to state stakeholders
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
Bachelor’s degree or equivalent experience
3+ years of experience in a role directly managing a compliance program
Experience leading audits and major program initiatives
Ability to identify root cause issues and ensure appropriate corrective action
Experience managing multiple projects/tasks; proven history of successful results in managing issues and driving strategic program initiatives
Proven ability to think strategically and to translate strategic directives into tactical initiatives
Proven ability to drive cross-functional teams to deliver operational compliance
Superior analytical, organizational and problem solving skills
Must live within commutable distance of the location listed for this specific career opportunity.
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
Advanced Degree (JD, MBA, MA etc)
Experience and knowledge working with Michigan Medicaid
Experience and knowledge working with state level regulators
Experience in a strategic role, ideally leading and implementing a comprehensive compliance program
Careers 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: Southfield, MI, Detroit, Medicaid, Office-based, Compliance, Regulatory, HIPAA, Managed Care, Government Program,