Regulatory Affairs Consultant

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Manages regulatory activities and projects in support of company strategies, departments, programs, and functional areas. In cooperation with department leadership, conducts research, develops work plans and action steps and carries them through to meet internal stakeholders' expectations. Stays current with regulatory requirements. Provides regulatory interpretation to internal stakeholders, performs audits, develops reports and tools to support compliance with regulatory requirements, contractual commitments, and accreditation expectations. Cooperates with management, collaborates with cross-functional teams, and monitors implementation of corrective measures. Knowledge of Federal and State regulations applicable to health plans and IPAs required. Reports to Executive Director, Department of Managed Health Care (DMHC) Engagement and Operations.

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

Primary Responsibilities:

• Maintain knowledge of current and impending regulations and legislation
• Triage and lead cross-functional teams for the implementation of complex new or existing regulatory issues, monitor, and communicate status
• Participate in the development of strategy in accordance with business goals for regulatory engagement and operations
• Provide regulatory interpretation to internal stakeholders, develop and manage work plans to meet company goals, including periodic monitoring and reporting, for adherence to regulatory requirements
• Serve as a conduit between regulators and operations, interprets requirements, centralize responses, create exhibits and reports, annual, routine, and ad-hoc under the oversight of leadership
• Provide regulatory expertise and guidance to internal stakeholders, answer questions with operationally relevant research and information
• Collaborate with various departments, and committees; assist in ensuring accurate and consistent understanding of applicable laws, present information and advice in accordance with regulatory requirements and initiatives
• Support and or develop responses to contracted health plans and regulatory authorities
• Serve as the point of contact and coordinate participation in regulatory agency audits and site visits
• Translate highly complex concepts in ways that can be understood by a variety of audiences
• Ensure policies and procedures language and format are current with applicable laws and regulations and conform to Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and National Committee for Quality Assurance (NCQA) expectations for language (including citation of required regulations, rules and standards, and confirmation of alignment of procedures with requirements)
• Develop and provide training on regulatory requirements
• Resolve highly complex business problems that affect clinical and operational processes and functional requirements
• Prepare documents and develop Executive level updates and reports
• Identify cost-effective opportunities and initiate innovative recommendations for cross-functional/cross CDO process improvements
• Support other functions and duties as assigned

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:

• 5+ years with health care regulatory and compliance matters, current knowledge of managed care operations and industry drivers
• 3+ years of direct experience leading designing, coordinating, and implementing complex work plans with short timelines and involving multiple contributors
• Experience driving cross-functional teams to deliver operational compliance
• Experience leading through change; Excellent relationship building skills
• Experience reading and interpreting documents such as CMS, DMHC, DHCS rules and regulations, policy and procedure manuals
• Experience collaborating with and presenting to groups of customers or employees of the organization
• Experience managing issues and driving strategic program initiatives
• Proven ability to think strategically and to translate strategic directives into tactical initiatives
• Adept at understanding complex concepts and situations presented by the business environment

Preferred Qualifications:

• Managing health care regulatory and compliance matters for a Health Plan
• Supervisory experience
• Direct experience achieving compliance with DMHC, DHCS, and CMS expectations
• Superior analytical, organizational, and problem solving skills
• Ability to adapt in a dynamic and high-growth environment. Objective, collaborative approach
• Able to accommodate and manage ambiguity, to work on abstract problems across functional areas and conceptualize/implement solutions
• Ability to multi-task in a fast-paced, rapidly changing environment

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $88,000 to $173,200 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

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