Compliance Director, Revenue Cycle Compliance Audit and Analytics - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

Quality at UnitedHealth Group means striving for excellence in everything we do in order to help us achieve our Mission. Simply put, it’s in our DNA and why we’re in business - to help people. Our Mission serves as our why; our Values unite us around how we will achieve it. Because when we follow our Mission and live our Values, we deliver Quality.  

We’re looking for a dynamic and visionary leader to lead revenue cycle compliance audit and analytics: 

• Lead with Impact:  Oversee and conduct comprehensive hospital and physician practice revenue cycle operational process and compliance audits. Lead, develop and mentor a team of 3 auditors and 3 analysts  
• Innovate and Optimize: Coordinate and develop data analytics and analysis, including automated platforms, to support revenue cycle compliance and monitor risks associated with patient access and billing workflows to enhance operational controls
• Stay Ahead of the Curve: Keep abreast of regulatory changes, educate your team on emerging risks, and develop cutting-edge monitoring models
• Collaborate and Influence: Engage with various levels of leadership within OptumInsight and our end-to-end clients, providing high-quality service and value-added solutions. Work closely with the Vice President of OptumInsight Provider Compliance, Compliance Directors responsible for revenue cycle management outsourced clients, Coding Audit Director and Legal counterparts

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Lead the design and development of compliance dashboards and models that provide insight on revenue cycle operations. Analyze and validate large, complex data files
• Manage the auditing of revenue cycle and regulatory risk topics as outlined in the audit plan to identify root causes of potential concerns and assist Operational Leaders in identifying corrective actions
• Utilize data to perform ongoing risk assessments to identify and analyze risk areas for the purposes of drafting, communicating, and executing auditing and monitoring initiatives. Identify and monitor business risks and process improvements
• Oversee preparation of clear and concise audit reports delineating scope and objectives, findings, root cause analysis, other observations, and recommended corrective actions for management
• Project manage the accurate and appropriate completion of corrective action plans by management
• Monitor and expand knowledge of emerging healthcare, compliance, and auditing trends, concepts, and techniques. Research and maintain awareness of new laws, rules, and regulations applicable to and impacting OptumInsight Provider operations

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:

• Professional designation in one of more of the following areas or similar:
  • Certified Healthcare Internal Auditor Professional (CHIAP)
  • Certification in Healthcare Compliance (CHC)
  • Certified Internal Auditor (CIA)
  • Certified Healthcare Financial Professional (CHFP)
• Significant experience communicating verbally and in writing with all levels of managing including executives 
• Significant leadership expertise in performance management, coaching and mentoring
• Expert hospital Revenue Cycle process knowledge gained through management, audit or compliance experience
• Expert in process auditing, including data acquisition and analytics, workpaper preparation, professional report writing and process visualizations
• Expertise in researching and auditing to Federal and State regulations, payer guidelines, regulatory agency publications and industry standards for hospitals and physician practices

Preferred Qualifications:

• Experience with EPIC, MS4, Meditech, SMS Invision, Cerner, Star and other Healthcare platforms or technologies
• SQL Development and SSMS experience
• Advanced level of proficiency with MS Word, Excel and PowerPoint
• Advanced level of proficiency with project management strategies

Total Compensation. As part of your total compensation package, which includes base, bonus opportunity, PTO and holiday pay, you will also receive these benefits at these rates, not to mention a remote work opportunity and healthy work/life balance.

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

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

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.

Salary : $104,700 - $190,400