573596 - Healthcare Provider Associate Compliance Director - Lake Success (Long Island) NY - Full-time / Part-time

Optum is a health services business, part of the UnitedHealth Group family of companies, dedicated to making the health system work better for everyone. We serve people throughout the entire health system. This allows us to bring a uniquely broad, yet experienced, perspective. We have the ability and scale to help our clients both envision and implement new approaches that drive meaningful, enduring and positive change. Beyond just a company and a brand, Optum is a unique and valuable collection of people, capabilities, competencies, technologies, perspectives and partners.  The people who work at Optum are among the brightest and most inventive in the industry. Work alongside us today and discover a culture of integrity, compassion, relationships, innovation and performance. Our team enjoys conversation-changing, life-changing, world-changing opportunities throughout their careers. Join us and see what it's like to do your life's best work.(sm)

The Optum Associate Compliance Director is responsible for supporting all aspects of the compliance program with focus on business operational compliance in provider and clinical businesses. As a key member of the Compliance Operations team, this position provides compliance leadership and oversight within assigned markets and businesses, and serves as a first point of contact for employees on compliance matters.

Position is based at our location in Lake Success (Long Island) NY.  Position will require approximately 25% travel (day trips) in the NY Metro area.

Primary Responsibilities:

• Partner with physician/business leaders to oversee compliance program implementation and effectiveness


• Develop business profile and work plans and ensuring timely completion of key milestones


• Develop/maintain regulatory and operational knowledge for assigned businesses


• Provide subject matter expertise and support for key regulatory implementation initiatives


• Conduct annual compliance risk assessment and support business remediation as necessary; risk assessment will include validation of standards, accountabilities and outcomes


• Deliver targeted compliance training and communications


• Provide subject matter expertise for compliance investigations, assessments, audits and reviews.


• Manage provider practice compliance committees (where required) and deliver periodic compliance reports to leadership


• Oversee remediation and corrective action plans resulting from audits, investigations, compliance reviews, and self-identified issues


• Assist with high-risk implementations


• Interface with regulators as needed


• Conduct compliance reviews of marketing materials, regulated documents and other external materials


• Conduct acquisition due diligence and manage compliance integration of acquired entities


• Ensure Vendor/Delegate Standards and Oversight support in alignment with Compliance Program Administration team


• Provide Subject Matter expertise for compliance operations within the provider practice and clinic environment


• Align coding, documentation and billing processes with the Optum Coding Compliance Program and standards

Required Qualifications:

• Bachelor's degree


• 5+ years of demonstrated experience leading and implementing a comprehensive physician practice Compliance Program, based on the seven elements


• Experience in developing and validating Compliance in clinic and physician practice environments


• Demonstrated ability to lead a team and influence in a large, matrixed organization


• 3+ years of experience working in the health care industry


• Experience with highly matrixed functional areas, business segments and external companies


• Self-starter with proven ability to drive cross-functional teams to deliver operational compliance


• Proven ability to think strategically and to translate strategic directives into tactical initiatives


• Adept at understanding complex concepts and situations presented by the business environment


• Ability to assess complex problems and recommend the appropriate compliance solutions


• Objective, collaborative approach; ability to adapt in a dynamic and high-growth environment


• Exceptional written, verbal, analytical, organizational, problem solving and presentational skills


• Experience managing multiple projects/tasks; proven history of successful results in managing issues and driving strategic program initiatives


• Ability to travel to provider locations; up to 25% of the time (day trips)

Preferred Qualifications:

• Post-graduate or law degree


• Experience with implementing the New York State Office of the Medicaid Inspector General (OMIG) provider compliance program regulations


• Clinical expertise and experience in Regulatory environment


• Professional certification in Healthcare Compliance

Optum is part of the UnitedHealth Group family of companies. At Optum, we don't just develop solutions. We create innovations that have the power to transform health care.  We want to make health care work better for everyone. That mission depends on hiring the best and brightest. Our team comprises high performers, challengers, risk-takers and curious minds who have compassion for the world around them. Optum employees know that their work will impact the lives of others.

UnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 14, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good. Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed. Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Diversity creates a healthier atmosphere: 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.

Job Keywords: Compliance, legal, regulatory, Lake Success, New York, NY, New Jersey, NJ, Connecticut, CT