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.The Compliance Director implements and manages the OptumInsight Provider Compliance Program at outsourced clients, including facility and physician/ambulatory revenue cycle services as well as and care coordination/utilization review, consistent with elements of an effective Compliance Program as outlined in the Sentencing Guidelines and DHHS Office of Inspector General guidance documents. Conducts risk assessments, evaluates regulatory compliance and develops Compliance Workplans. Works with business operations and QA teams to implement and manage ongoing monitoring of standard Compliance metrics and corrective action plans. Investigates reported Compliance/Ethics incidents. Evaluates compliance with applicable regulatory requirements and drives problem resolution and solutioning for identified compliance and quality concerns. Develops regular status reports for client and regularly coordinates with client compliance contacts.You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:

Implement and provide ongoing management of OptumInsight Provider Compliance Program at revenue cycle end-to-end outsourced clients, including facility, physician/ambulatory, care coordination and other in scope services

Coordinate annual compliance education, conduct risk assessment, develop and execute annual compliance work plan

Evaluate revenue cycle processes for accuracy and regulatory compliance, including patient access/registration and billing. Advise on appropriate process leading to accurate billing

Implement ongoing monitoring processes, evaluate data and determine appropriate corrective actions

Participate in new client onboarding processes by evaluating existing client risk areas and working with business operations. Coordinate with operations and QA teams to implement ongoing monitoring of standard Compliance metrics

Verify compliance with various regulatory requirements and drive problem resolution and solutioning for identified compliance and quality concerns

Analyze and advise on operational impacts to new federal and state regulations. Evaluate appropriateness of management implementations

Provide written and verbal status updates and reports to the client. Participate in client meetings and regularly coordinate 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:

5+ years of hospital/health system compliance program experience

Certified in Healthcare Compliance, CHC; Certified Internal Auditor, CIA; or related certification

Working knowledge of CMS and other regulatory billing requirements

Proven ability to work collaboratively with operational and client leaders

Proven ability to multitask, takes the lead on projects, complete projects, collaborate with others to identify problems and related resolution.

Proven exceptional technical skills in Excel, Word, and PowerPoint

Proven solid data analysis skills

Preferred Qualifications:

3+ years supervisory experience

Hospital operational revenue cycle experience

Hospital operational experience

Experience working in a client-facing role

Excellent written and verbal communications

High ethical standards and ability to maintain confidentiality

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $104,700 to $190,400 per year. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyAt 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 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.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.