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Sr. Regulatory Adherence Analyst - Telecommute

Company: UnitedHealth Group
Location: Minnetonka
Posted on: June 21, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)The Sr. Regulatory Analyst will be apart of Government Operations team, a great team of experienced specialist supporting operational business functions for Community & State (C&S), Medicare & Retirement (M&R), and Individual and Family Plan (IFP) oversight. In this role, you will be responsible for understanding and managing State, Federal, Contractual, and regulatory requirements impacting our business. -Meeting regulatory requirements is foundational for our members and providers experience and our own reputational brand. Providing consultation to support business partner decision making from a regulatory lens which aids in the transformation, improvements, execution, and risk mitigation. -We partner with operations and other key business owners to bring clarity, awareness, and understanding to regulatory requirements and potential risks. We seek to advise operations on ways to mitigate risk while improving the systemic process. We empower operations with information, guidance, and tools to make sound regulatory decisions.You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. -Primary Responsibilities:

  • Conduct root cause analysis of Compliance results to identify trends, issues, patterns, or process improvements within Government Operations related to potential non-compliance issues identified through Regulatory activities both external and internally in the organization
  • Assist Operational Business Leaders with implementation of corrections and/or changes which will drive and improve Regulatory Adherence within Gov Operations
  • Document and track the root cause analysis performed on Compliance Results. -Detection of business practices that may be malfunctioning and/or where the business is not meeting regulatory requirements
  • Works with key Operations Leaders, Compliance, Health Plans & Legal across the lines of business to support the business implementation of effective compliance procedures and reporting regulatory monitoring or control measures
  • As dictated by trending performance, identify key areas to begin process improvement initiatives based on State, Federal, or Contractual Regulations & engage the right leadership to create industry wide knowledge for the Operational Regulations (National). Escalating high risk issues immediately with leadership
  • Review and prepare incoming legislation for State, Federal, and Contractual requirements for dissemination to the applicable Business areas
  • Provide Regulatory guidance to business on new Regulatory requirements or engage the appropriate resources to assist the business with operational changes
  • Ensure all UHC Government Operations Regulations are entered into the organizations centralized tracking platform -
  • Validate Government Operations completion of new Regulatory requirements at oversight level
  • Review of reporting and data for accuracy and completeness which is used to support your direct managers regular reporting cadences with Business Leaders and Executive Leadership in driving business processes, training needs, and Auditing Risks
  • Lead preparation and maintain regulatory overviews for monthly reviews with VP's of business functional areas discussing Regulatory concerns for their Business area(s)
  • Implement tools and processes that detect problem areas, perform analysis to understand root cause of the error and oversee remediation for error correctionYou'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 working with Regulatory Requirements at State and Federal levels -
    • 3+ years of experience researching -
    • Experience in MS Office Suite (Word, Excel, etc.) intermediate level or higher
    • Experience interacting and collaborating with a variety of stakeholders (colleagues, internal business partners, and management)
    • General Understanding of Medicare and Medicaid Regulatory Requirements for Claims processing -Preferred Qualifications:
      • Degree or equivalent experience: Bachelor's degree
      • Experience with Claims CSP Platform -
      • Experience with Regulatory agency websites and application portals or researching of requirements -
      • Research and obtain information from applicable internal and external resources to facilitate resolution of complainant issues
      • Exceptional written and verbal communication skills
      • Self-motivated contributor who takes ownership of a task from start to finish
      • Superior analytical, organizational, and problem-solving skills
      • Ability to effectively deal with ambiguity and change, can shift gears comfortably, can act with information available, comfortably handle uncertainty in a manner consistent with UnitedHealth Groups core values, culture, and common language of leadership
      • Ability to identify when decisions must be escalated to leaders because information is limited or unclear
      • Ability to identify problems and support the appropriate compliance solutions
      • Ability to meet goal(s), work independently to achieve goals, and push self to reach milestonesTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmentCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada residents is $72,800 to $129,900. 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 Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/AffirmativSe 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 bylower 48 law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Minnetonka , Sr. Regulatory Adherence Analyst - Telecommute, Professions , Minnetonka, Minnesota

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