Compliance Director – Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together

Quality at UnitedHealth Group means striving for excellence in everything we do in order to help us achieve our Mission. Simply put, it’s in our DNA and why we’re in business — to help people. Our Mission serves as our why; our Values unite us around how we will achieve it. Because when we follow our Mission and live our Values, we deliver Quality.  

Step into a pivotal role where you will lead the OptumInsight Provider Compliance Program for outsourced clients, supporting a compliance program that aligns with the highest standards set by the Sentencing Guidelines and DHHS Office of Inspector General. As a Compliance Director you will: 

 Lead with Impact: Oversee compliance across facility and physician/ambulatory revenue cycle services, care coordination, and utilization review.

Innovate and Solve: Conduct risk assessments, develop annual Compliance Workplans, and drive innovative solutions to regulatory challenges.

Collaborate and Influence: Work closely with operational leaders and support them in meeting various requirements.

Team Up for Success: Partner with the Vice President of OptumInsight Provider Compliance, other Compliance Directors, the Coding Audit Director, Revenue Cycle Audit Director, Legal and Quality Assurance counterparts as well as interact with various levels of leadership within OptumInsight and our clients, delivering high-quality service and value-added solutions.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.   

Primary Responsibilities:

• Program Implementation & Management: Oversee the OptumInsight Provider Compliance Program at client sites. Monitor compliance with various metrics and support alignment with regulatory requirements
• Risk Assessments & Compliance Evaluation: Conduct comprehensive risk assessments, evaluate regulatory compliance, and develop and implement compliance workplans
• Collaboration & Monitoring: Partner with business operations and quality assurance teams to implement and manage ongoing monitoring of standard compliance metrics and corrective action plans
• Incident Investigation: Investigate reported compliance concerns, ensuring thorough documentation and resolution
• Regulatory Compliance & Problem Resolution: Evaluate compliance with applicable state and federal regulatory requirements, driving problem resolution and developing solutions for identified compliance and quality concerns
• Reporting & Coordination: Develop regular status reports for clients and maintain consistent communication with client compliance contacts

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:

• Professional designation in or more of the following areas or similar:  
  • Certification in Healthcare Compliance (CHC)
  • Certified Internal Auditor (CIA)
• Significant experience communicating verbally and in writing with all levels of managing including executives
• Extensive experience with hospital revenue cycle processes and regulatory requirements, including patient access/registration, billing and collections
• Expert in managing and monitoring a health system compliance program consistent with DHHS Office of Inspector General Compliance Program Guidance, including risk assessment, auditing and monitoring
• Expert in researching and assessing compliance with Federal and State regulations, payer guidelines, regulatory agency publications and industry standards for hospital and physician practice revenue cycle

Preferred Qualifications:

• Advanced level of proficiency with MS Word, Excel and PowerPoint
• Advanced level of proficiency with project management strategies
• Proven excellent analytical and problem-solving skills

Total Compensation. As part of your total compensation package, which includes base, bonus opportunity, PTO and holiday pay, you will also receive these benefits at these rates, not to mention a remote work opportunity and healthy work/life balance.

 

UHG Benefits   

Benefits pricing

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.