Sr. Account Manager Client Services - Telecommute

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)  
  
The Clinical Compliance Manager is responsible for the development and/or on-going management and administration of Model of Care (MOC) requirements across all Public Sector Programs.  The Clinical Compliance Manager will partner with Program leadership to ensure compliance with the MOC requirements are included in the program design. This position will ensure all auditing and reporting is in place to monitor our compliance.  The Clinical Compliance Manager will partner with all Programs leadership and our External Partners on all regulatory requirements.   Our mission is to help people live their lives to the fullest. Our values are Integrity, Compassion, Relationships, Innovation, and Performance.  
  
**This is a Telecommute / Work From Home position.  Candidate must live anywhere in the Eastern or Central time zone.*** 
  
Primary Responsibilities:  

Forecasts and plans resource requirements
Collaborate with applicable stakeholders to promote adherence to compliance programs among employees within their scope of influence
Develop/implement/facilitate auditing/monitoring processes to identify program issues and help the business address them (e.g. Implementation issues, training needs, exceptions to program requirements)
Respond to reported compliance issues and develop/facilitate corrective actions as necessary
Anticipates customer needs and proactively develops solutions to meet them
Serves as a key resource on complex and/or critical issues
Solves complex problems and develops innovative solutions
Evaluate processes and outcomes against benchmarks and metrics and identify potential business impacts of current state
Prepare reports or document evaluation results
Coordinate with others to develop program or process implementation plans
Secure buy-in from key stakeholders to program or process implementation plans
Provide operational or subject matter expertise to train others on program or process components (e.g., strategy, implementation)
Demonstrate understanding of the impact of applicable laws, regulations, mandates and contracts on our business and operations, including both segment-specific and enterprise-wide implications
Collaborate with applicable internal partners (e.g., Legal) to help interpret and apply laws, regulations, and contracts appropriately within specific business settings
Facilitate understanding of applicable laws, regulations, mandates and contracts with specific audiences (e.g., business leaders, product owners, business operations, board members)
  
Demonstrate Knowledge of Business and Industry Processes, Policies and 
Procedures 

Demonstrate knowledge of knowledge of the healthcare industry and associated processes and procedures
Demonstrate knowledge of applicable business processes, structures and functions, including applicable vendors and delegated entities
Demonstrate knowledge of applicable product lines
Demonstrate knowledge of applicable contracting processes
Demonstrate knowledge of applicable risk management approaches
Demonstrate knowledge of Compliance Program policies, procedures and documentation
Demonstrate knowledge of UnitedHealth Group Code of Conduct and associated best practices
Document, Communicate and Report Compliance Status and Issues 

Gather and maintain compliance-related data from applicable systems/databases for use in reporting/communications
Develop and update compliance scorecards/reports, and communicate to applicable stakeholders (e.g., Key Compliance Indicators)
Develop open lines of communication with all relevant stakeholders to confirm their buy-in and understanding of compliance and associated risk
Identify and communicate compliance status and issues to applicable audiences (e.g., business leaders, product owners, b business operations, board members)
CPL_Provide Training and Consulting on Compliance Program Requirements and Risks  

Develop and/or deliver training on compliance issues and risks to applicable audiences
Consult with internal and external stakeholders to advocate and drive effectiveness of our compliance programs (e.g., government)
Develop and/or deliver training on compliance issues and risks to applicable audiences
Consult with internal and external stakeholders to advocate and drive effectiveness of our compliance programs (e.g., government regulators, legal staff)
Partner with applicable learning organizations as needed to develop/implement compliance training offerings (e.g., Learning & Development)
Consult with applicable business partners to identify effective approaches to support/enforce compliance within their business
Provide input on business training programs as needed to promote inclusion of appropriate compliance content (e.g., specialized compliance training)
Assess and respond to the need for required compliance training

Required Qualifications:  

Active, unrestricted RN license in your state of residence
2+ years of managing people (direct reports)
Previous Case Management experience
Regulatory and Compliance experience
Computer proficiency and technical aptitude
Strong written, communication, and presentation skills
Leadership and mentoring skills
Ability to work in a rapidly changing environment by being adaptable and flexible
  
Preferred Qualifications:  

BSN
Certified Case Manager (CCM)
Program/Project Management experience
Experience working in a provider office or with provider groups
  
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) 
  
  
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: manager, project manager, program manager, RN, registered nurse, provider, ccm, case manager, stars, practice based support, black belt, green belt, telecommute, work from home, remote