Program Integrity Director Jobs in Baltimore, MD

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

This Compliance Director will serve in a role providing direct support to UnitedHealthcare Community & State (C&S) compliance program and health plan compliance priority functions as defined.

Primary Responsibilities:

• Ability to manage elements of a health plan compliance program with an understanding of state-based government health care programs and products
• Engage in complex remediation strategy & resolution and promote compliance with applicable laws and contractual obligations for various Medicaid products
• Ability to flex by working across different markets with varying needs and expectations, as well as across the broader national compliance teams and various compliance program focus areas as needed
• Evaluate compliance program functions and offer recommendations for continuous improvement
• Conduct product-specific research (in collaboration with other regulatory affairs and legal teams) to identify state Medicaid requirements
• Partner with legal, compliance and program integrity professionals to support national and market program integrity activities and communications
• Collaborate with other legal, regulatory affairs, and compliance professionals cross-functionally to ensure elements of the compliance program are executed and that regulatory and contractual requirements are met
• Evaluate identified compliance issues, including corrective action and mitigation

This role requires an ability to develop relationships, analyze information, recommend process improvements and influence multiple stakeholders to increase engagement and get the needed results. You will be working in a matrixed environment with multiple groups while ensuring that resources are used effectively to mitigate risks and achieve compliance.

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:

• 3 years of experience managing aspects of a compliance program or working in a regulatory position
• 3 years of experience working in a government, legal, healthcare, managed care and/or health insurance environment in a regulatory, privacy or compliance role
• Experience managing teams, major program initiatives or working with regulatory agencies
• Broad knowledge and experience in: Ability to navigate and influence a complex matrixed environment across UHC, Optum and other delegated entities and drive to resolution
• Proven solid skills in: goal(s) setting and works independently to achieve them. Pushes self and others to reach milestones
• Proven excellent skills in: verbal and written communication; problem solving
• Demonstrates advanced writing/presentation skills. Easily shifts style based on audience
• Demonstrated ability to make decisions even when information is limited or unclear
• Proven adept at understanding and resolving complex concepts and situations presented by the business environment; ability to assess complex problems and recommend the appropriate compliance solutions
• Located in Eastern time zone

• Proven ability to effectively deal with ambiguity - can effectively cope with change, can shift gears comfortably, can decide and act without having the total picture, comfortably handles risk and uncertainty in a manner consistent with UnitedHealth Groups core values, culture and common language of leadership 

Preferred Qualifications:

• Willing to work from the Columbia, MD office hybrid 4 days a week
• Professional certification (Certified in Healthcare Compliance - CHC or similar)
• 5 years of healthcare industry or healthcare related industry and government programs experience
• Experience with managed care and/or government programs
• Experience in a strategic role, ideally leading and/or implementing a comprehensive compliance program

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

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