Director, External Audit – 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.  

OptumRx is an innovative pharmacy benefit management organization managing the prescription drug benefits of commercial, Medicare, and other governmental health plans, as well as those of employers and unions. Services offered by the company include pharmacy network contracting, rebate contracting and administration, mail order pharmacy facilities, specialty drugs, and retail drug claims processing. OptumRx is part of Optum, a leading information and technology-enabled health services business dedicated to making the health system work better for everyone.

The Director External Audit will oversee the Company’s response to high priority audits/market conduct examinations (MCEs) initiated by commercial regulators and have responsibility for monitoring audit progress, addressing bottlenecks, and escalating critical issues to leadership. This senior-level position is integral to ensuring the organization’s compliance with regulatory requirements and maintaining the integrity of OptumRx’s operations.

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

Primary Responsibilities:

• Oversee and manage audits and MCEs conducted by state regulatory agencies across OptumRx’s commercial business
• Monitor ongoing audits, identify and address bottlenecks, and escalate critical issues to senior leadership as needed
• Support the development and maintenance of MCE reporting to governance and risk management stakeholders
• Enhance and refine exam management standards and processes 
• Lead the preparation, coordination, and submission of responses to regulatory audit/ MCE requests and findings, ensuring timely and accurate completion of all documentation and communication
• Serve as the primary point of contact for regulatory agencies during the audit process. Maintain effective communication with internal stakeholders to keep them informed of audit status and resolutions
• Partner with the business and colleagues across legal, compliance, and regulatory affairs to develop appropriate corrective action plans and successfully resolve audits
• Support root cause analysis of confirmed audit findings in coordination with business teams

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:

• 8+ years of Market Conduct Examination/Department of Insurance expertise (i.e. state audits, market conduct exams, surveys and investigations)
• 8+ years of experience in audit (operational, financial, and/or IT related)
• 8+ years of experience in a healthcare regulatory environment
• Project management experience
• Experience working well under tight timelines and adapting to change in a fast-paced and team-oriented environment
• Intermediate level of proficiency with MS Word, Excel and PowerPoint
• Ability to travel domestically on occasion

Preferred Qualifications:

• Professional certification (e.g., CPA, CIA, CFE) 
• 8+ years of experience with HIPAA, state and privacy laws
• Experience working with the pharmacy and pharmacy benefits management industries
• Sound understanding of regulatory standards and audit practices 
• Proven superior oral, written communication and interpersonal skills
• Proven superior analytical, organizational and problem-solving skills

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

The salary range for this role is $124,500 to $239,400 annually based on full-time employment. 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.