Health Plan Compliance Officer – Des Moines, IA

Job Listing No: 9740000

Health Plan Compliance Officer – Des Moines, IA

Details: Bring us your experience, your head for strategy, your strength with relationships and your eye for opportunity. In return we offer an unmatched place to grow and develop your career among a richly diverse group of businesses driven by the power and stability of a leading health care organization. Come help us heal and strengthen the health care system as you do your life’s best work.(sm) UnitedHealthcare Community & State, part of the UnitedHealth Group family of companies, is looking for an experienced Compliance Officer to join our dynamic Compliance team. Things are exciting at UHG as we are experiencing unprecedented growth, and looking for someone for a leadership position on our team in Des Moines IA. The Compliance Officer is an individual contributor role responsible for supporting all aspects of the compliance program for our Iowa Medicaid Healthplan. This position reports directly to the Regional Director of Compliance and indirectly to Plan Leadership, and serves as a first point of contact for state regulators on compliance matters related to the plan. Provides leadership to and is accountable for the performance and results through multiple layers of management and senior level professional staff. The Compliance Officer will monitor changes to laws and regulations to ensure compliance with State & Federal laws, regulations and mandates. This individual will develop, implement and maintain the compliance program within UnitedHealthcare Community & State in order to ensure that we are meeting company guidelines and CMS requirements. They will establish and implement standard policies, procedures, processes and best practices across UnitedHealth Group to promote compliance with applicable laws and contractual obligations. The Compliance Officer will conduct state-specific research and monitor changes to requirements to mitigate risks and achieve compliance. Will also support the collection of data for regulatory filings, coordinate and develop reports, projects, and assessment tools to verify compliance. They will develop compliance communications and drive problem resolution for a business. Ideal candidates will have experience in a Iowa Medicaid regulatory or compliance role (from either a health insurance company or from government), will have experience working with state level regulators, will have experience working with OIGs, and will have strong project management experience and experience working in a matrixed environment. Primary Responsibilities: Develop and manage site Compliance Committee meetings Ensure written standards and procedures Provide training, communications and education Ensure proper reporting and response to state stakeholders Conduct auditing and monitoring, to ensure compliance Oversee contract compliance activities and vendor oversight Remain vigilant regarding fraud, waste and abuse Ensure privacy requirements are met within the health plan

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