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Regulatory Compliance Manager - Telecommute job at UnitedHealth Group, San Jose

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UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Compliance Manager must be a person of high integrity with demonstrated leadership and management skills capable of effectuating change in a large organization.  This position is primarily responsible for the ongoing daily activities of Compliance, including but not limited to, compliance and HIPAA program management, auditing, monitoring, HIPAA, investigative and reporting throughout MCNA.  This position is also responsible for discovering, analyzing and disseminating any proposed or enacted legislation or state regulations that may impact the Company.  

Reports to:
Director of Compliance and Privacy

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

Primary Responsibilities:

  • Assists in the development of education and awareness materials and promotes activities that foster compliance and privacy awareness within the company
  • Develops, implements and oversees the execution of work plans
  • Leads the day-to-day execution of other key initiatives and drive departmental goals in support of those initiatives
  • Provides leadership and work direction for compliance specialists and coordinators
  • Creates the structure and processes necessary to manage internal oversight activities
  • Assists with internal risk assessment and accreditation activities
  • Collaborates with Operations, Quality Improvement and Dental Management to facilitate monitoring and oversight activities in support of an effective Compliance Program
  • Assists with the development of compliance related risk profiles for internal operations and/or delegated vendors
  • Partners with Operations, Dental Management, Quality Improvement, Finance and Information Technology to assure regulatory reporting and/or submissions are submitted in accordance with regulatory requirements
  • Assures compliance oversight and monitoring activities are documented in accordance with department standards, and respective findings are adequately supported
  • Represents the department in quarterly cross-functional committee meetings and periodic operational meetings when the Director is unavailable
  • Ensures adequate communication, training, monitoring and reporting systems are in place to accomplish regulatory contract compliance on a consistent basis
  • Leads or contributes to compliance oversight projects with aggressive deadlines
  • Develops intra-departmental processes and relationships
  • Establishes effective inter-departmental training programs
  • Demonstrates understanding of compliance aspects of contract provisions, company specific rules, governmental and agency regulations, and accrediting organization standards
  • Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language
  • Perform privacy reviews and monitoring efforts, projects, incidents reporting, breach reporting, training, and presentations
  • Serves as an internal resource/consultant to the company for privacy-related activities
  • Must be able to perform all duties of lower level positions as directed by management
  • Other duties as assigned


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:

  • Bachelor’s degree in related field 
  • 3+ years in health care, Medicare or Medicaid programs, audits or contract compliance experience 
  • 3+ years management and training experience 

Preferred Qualifications:

  • Master’s degree 
  • Experience working independently and responding to rapidly changing priorities
  • Experience working on and leading cross-functional projects or with cross functional project teams
  • Knowledge and understanding of health care laws, regulations, and standards
  • Computer skills including Microsoft Office’s suite of software applications
  • Solid problem solving and project management skills and the ability to work with minimal supervision
  • Exceptional organizational and leadership skills 
  • Solid communication and relationship building skills 
  • Solid analytical, critical thinking and problem solving skills
  • Ability to use critical thinking skills to interpret, evaluate, clarify and explain complex processes and requirements to staff and internal departments with the intent to identify and mitigate regulatory compliance issues
  • Ability to work under pressure and within strict time frames
  • Ability to maintain confidentiality
  • Ability to understand, interpret, and communicate healthcare compliance laws and   regulations

For all Positions:

  • All employees shall meet Compliance/Privacy/ Fraud and Abuse Regulations, and attend a Compliance/ Privacy/ Fraud and Abuse educational training annually, as required by law /MCNA Dental Plans
  • All employees shall meet Risk Management Regulations, and attend Risk Management education and training within the first thirty (30) days of employment and as required by law or MCNA Dental Plans; and, for those non-dental in clinical or direct care delivery services, annually thereafter
  • All employees if duly licensed in a State and said license is part of the requirement of their position with MCNA Dental Plans, shall maintain in good standing and current state licensure
  • All employees are required to maintain confidentiality, protect privacy, comply with PHI regulations, and report violations


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada residents is $72,800 to $129,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/AffirmativSe 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 bylower 48 law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.


Job country: United States

City: San Jose

Category: Compliance Managers

Location: San Jose, CA, United States

Job posted 2022-06-04

This job is expired

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