1+ months

Compliance Manager - Long Island, New York

New York, NY 10007
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No other industry is changing as rapidly or as broadly as health care. But to us, change is invigorating. It gives us a chance to continue to innovate as we shape the future. As a Compliance Consultant with us, you will monitor changes to laws and regulations to ensure compliance with State and Federal mandates. It's an exhilarating pace where you can develop your career while you help to make the health system work better for everyone.

The manager is an individual contributor role responsible for supporting all aspects of the compliance program with focus on care delivery organization compliance program administration.

Primary Responsibilities:
  • The Manager of Compliance has responsibility for managing the implementation and ongoing effectiveness of the Optum Compliance Program at the assigned care delivery organization
  • General duties and responsibilities encompass implementing Optum systems, processes and policies designed to ensure compliance with Federal healthcare program requirements at the care delivery organization (CDO)
  • Among the specific responsibilities and activities are the following:
    • Work collaboratively with CDO leadership in compliance and ethics program implementation
    • Establish effective working relationships and build credibility within the CDO to support a culture of ethics and compliance
    • Provide subject matter expertise to the Optum Investigations team on reports of noncompliance, received via ethics hotline or otherwise
    • Actively monitor completion status for all required compliance training modules via the Learning Management System (LMS)
    • Ensure dissemination and access for all staff to compliance policies and procedures and the UHG Code of Conduct
    • Partner with Optum legal counsel on matters impacting the CDO as appropriate
    • Conduct an annual risk survey to identify areas of material compliance risk to the business
        • Assist with the development of auditing, monitoring and oversight processes related to identified risks (controlled substances, professional licensing/credentialing, etc.)
    • Support all audit and survey activities impacting the CDO
    • Oversee implementation of remediation and corrective action plans, resulting from audits, investigations, compliance reviews, and self-identified issues
    • Build relationships that encourage CDO employees, leadership, contractors and physicians to report suspected fraud or other improprieties without the fear of retaliation
    • Chair the Compliance Committee, which provides a venue for discussion of identified risk areas, areas of non-compliance or potential risk and non-compliance.  Collaborate with business subject matter experts to develop appropriate content for the committee meetings. Compliance Committee should include active engagement of the business leaders and subject matter experts
    • Track all compliance activities / issues within the OptumCare Compliance Online Tracker
    • Implement the OptumCare compliance work plan, initiatives and systems to prevent compliance issues from arising
    • Complete a monthly dashboard for each business supported providing a current status of key compliance indicators
    • Report to CDO leadership on compliance matters on a routine basis
    • Develop/maintain product, regulatory, and operational knowledge for assigned businesses, with particular focus on provider practice standards and regulatory requirements
    • Coordinate with Privacy Office as needed
    • Coordinate and collaborate with Practice Health & Safety team and business clinical leadership to track trends in assessment outcomes and timely completion of any required corrective actions
    • Provide counseling and support for key regulatory implementation initiatives
    • Oversee and review operational policy and procedure development as needed
    • Deliver targeted compliance training and communications
    • Conduct compliance reviews of marketing materials, regulated documents and other external materials
    • Conduct compliance assessments as appropriate
    • Actively engage with Optum / OptumCare enterprise compliance initiatives and research
Posted: 2019-07-26 Expires: 2019-09-28

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Compliance Manager - Long Island, New York

UnitedHealth Group
New York, NY 10007

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