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in Boston, MA

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Hours Full-time, Part-time
Location Boston, MA
Boston, Massachusetts

About this job

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)
 
 
Optum’s Program Integrity (PI) operations for the Massachusetts LTSS project are headed by a Program Integrity Lead who will provide oversight of all of the PI components of the contract, specifically being responsible for meeting contractually required deliverables, work assignments, quality and production standards. The PI lead is:Accountable operations are being monitored, tracked and progressively moving towards the project goals. The liaison with OLTSS to discuss PI contract-related issues, responsibilities, and deliverables and promote seamless processes.Represents OLTSS in PI hearings and appeals process as necessaryMaintains operational oversight of the Audit and Review Team Obtains required approvals of audit candidates from OLTSS Leads monthly LTSS Provider Review Committee meetings to review audit findings, identify areas of potential abuse, sanctions and coordination of PI activities Conducts quality assurance activities and participate in Optum Quality Improvement Committee Develops the annual Audit Plan with assistance from other team members Transmits audit results to OLTSS Maintains appropriate Audit Team staffing levels and assign workloads Hires, trains and manages Audit Team staff Produces and submits required reports according to established time guidelines Assists in establishing and maintaining relationships with OLTSS, other agency staff, and the provider community as appropriate

Requirements

Bachelors Degree Project Management Professional preferred5 years or more implementing and managing projects in health care or government environment
 
 
 
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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.