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This District of Columbia Compliance Officer will serve in a role providing direct support to UnitedHealthcare Community & State (C&S) compliance program and health plan compliance priority functions as defined. 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. This position follows a hybrid schedule with four in-office days per week in Washington, DC.
Responsibilities
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.
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.
Requirements
3+ years of experience managing aspects of a compliance program or working in a regulatory position.
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.
Broad knowledge and experience in: Ability to navigate and influence a complex matrixed environment across UHC, Optum and other delegated entities and drive to resolution.
Proven solid skills in: goal(s) setting and works independently to achieve them. Pushes self and others to reach milestones.
Proven excellent skills in: verbal and written communication; problem solving.
Demonstrates advanced writing/presentation skills. Easily shifts style based on audience.
Demonstrated ability to make decisions even when information is limited or unclear.
Proven adept at understanding and resolving complex concepts and situations presented by the business environment; ability to assess complex problems and recommend the appropriate compliance solutions.
Proven ability to effectively deal with ambiguity - can effectively cope with change, can shift gears comfortably, can decide and act without having the total picture, comfortably handles risk and uncertainty in a manner consistent with UnitedHealth Groups core values, culture and common language of leadership.
Currently reside in/around Washington, DC.
Nice-to-haves
Professional certification (Certified in Healthcare Compliance - CHC or similar)
5+ years of healthcare industry or healthcare related industry and government programs experience.
Experience with managed care and/or government programs.
Experience in a strategic role, ideally leading and/or implementing a comprehensive compliance program.
