Remote Audit Readiness Jobs in Virginia (NOW HIRING)

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

The Chief Operating Officer (COO) serves as a key member of the executive leadership team and is responsible for the day to day operational performance of the health plan, ensuring consistent execution of the Cardinal Care Managed Care Contract with the Virginia Department of Medical Assistance Services (DMAS). This role provides enterprise wide leadership across operations, clinical delivery support, network operations, compliance execution, and operational readiness-translating strategy into disciplined, reliable operations that deliver high quality, compliant, and member centered outcomes across the Commonwealth of Virginia.

The COO partners closely with the CEO, Chief Medical Officer, Chief Financial Officer, Chief Compliance Officer, and functional leaders to ensure operational excellence, audit readiness, and solid performance against contract, quality, financial, and stakeholder expectations under Cardinal Care.

You'll enjoy the flexibility to work remotely* from anywhere within the U.S., preferably in VA, as you will be required to travel 50% within the VA Market as you take on some tough challenges.  

Primary Responsibilities: 

Operational Leadership & Execution

• Leads relationship management on all Operations related areas for the Cardinal Care program with the DMAS and all other State government agencies who have regulatory oversight of elements of the Cardinal Care/DSNP program to influence program design, develop support for program efforts, and secure approvals
• Lead and oversee core health plan operations (provider & member related, network, IT, claims, etc.)  ensuring effective implementation of all Cardinal Care contract requirements across covered populations, regions, and services
• Translate enterprise strategy and DMAS commitments into clear operational priorities, workflows, performance metrics, and accountability structures
• Ensure operational consistency and scalability across regions while supporting local engagement and region specific execution aligned with DMAS expectations
   

Regulatory Compliance & Audit Readiness

• Maintain operational readiness for DMAS, CMS, EQRO, operational, and financial audits, ensuring timely, accurate, and coordinated responses
• Partner with Compliance and Legal to embed contract compliant processes, internal controls, and monitoring into daily operations
• Support ongoing review and implementation of contract amendments and policy updates in coordination with DMAS
   

Clinical & Care Delivery Operations (Operational Oversight)

• Provide operational oversight and support for care management, care coordination, behavioral health integration, LTSS operations, and population specific programs, ensuring alignment with Cardinal Care delivery models
• Collaborate with the CMO and clinical leaders to ensure operational infrastructure supports quality improvement, clinical outcomes, and member experience goals
   

Network, Member & Provider Operations

• Oversee operational functions supporting provider network performance, member services, grievances and appeals, enrollment support, and service delivery performance
• Ensure operations are structured to support provider engagement, timely issue resolution, and service accessibility across all regions of the Commonwealth
   

Performance Management & Continuous Improvement

• Establish and monitor operational KPIs, dashboards, and management routines tied to quality, compliance, financial stewardship, and stakeholder satisfaction
• Lead continuous improvement initiatives to enhance efficiency, reduce operational risk, and improve service reliability while maintaining compliance
   

People, Culture & Cross Functional Leadership

• Lead, mentor, and develop operational leaders, fostering a culture of accountability, collaboration, and operational excellence
• Promote solid cross functional integration between operations, clinical, compliance, finance, and shared services
   

External & Stakeholder Engagement

• Serve as a senior operational liaison to DMAS and other state partners as appropriate, supporting clear communication, issue resolution, and trusted relationships in partnership with the CEO and executive team
• Build, develop, improve, influence and expand relationships with providers, community-based organizations/partners, and other stakeholders within the market and foster collaborative partnerships

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 experience working with FQHCs, Community Based Organizations, and State regulatory agencies
• 5 years of experience working in Managed Medicaid
• 5 years of experience leading operations, strategic planning, and development
• Ability to handle ambiguity
• Ability to travel up to 50% throughout the State of VA
• Driver's License and access to reliable transportation

Preferred Qualifications:  

• Executive level experience in dealing with multiple State Agencies
• Reside in Virginia  

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

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 $159,300 to $273,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.    

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.