At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
Ensure we are meeting Mental Health Parity requirements
Act as an MHP Subject Matter Expert (SME)
Collect, monitor, and document changes to requirements to mitigate risks and achieve regulatory adherence
Facilitate internal and external audits working with UHC Compliance and/or Market Conduct Exam teams
Manage escalated Mental Health Parity inquiries from either state/federal regulators or internal business partners
Ensure written standards and procedures
Provide MHP training, communication, and education
Support the collection of data and coordinate/create responses to MHP inquiries, audits, and exams
Acts as a liaison between teams coordinate implementation activities
Ensure proper reporting and response to state/federal and internal stakeholders
Conduct monitoring activities to ensure compliance with MHP program infrastructure
Provide support for and participate in regulatory audits
Coordinate response to Market Conduct Exam and state audit MHP inquiries or objections and ensure they are consistent with UHC parity standards and processes
Conduct MHP state-specific regulatory research with ability to understand and operationalize state and federal laws, as well as obtain Legal, Compliance, & Regulatory Affairs (LCRA) input as needed
Participate in the development of business strategy to meet MHP requirements
Ensure written MHP standards and procedures are reviewed and refined in collaboration with the internal SMEs from LCRA and key business leaders
Facilitate research and response to state or internal business partners’ escalated issues, inquiries and questions related to MHP including, but not limited to:
Provider reimbursement issues
Network adequacy issues
Payment Integrity
Clinical and operational processes
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:
5+ years of experience in business operations, regulatory, and/or compliance (preferably working in a government, healthcare, or managed care environment)
Demonstrated understanding of the following:
clinical operations
business operations (claims, network)
navigating across departments in the enterprise
Medicaid/commercial insurance experience
Demonstrated intermediate or better proficiency using SharePoint, MS Word, MS Excel, and MS PowerPoint
Demonstrated ability to communicate effectively across multiple departments and with all levels of leadership
Proven ability to manage multiple projects/programs
Ability to stay organized and practice effective time management skills
Ability to work effectively and congenially with employees at all levels
Demonstrated objective, collaborative approach; relationship builder who strives to build partnerships
Proven technical writing skills
Preferred Qualifications:
5+ years of experience working in a government, healthcare, managed care, or health insurance environment
5+ years of experience with regulatory filings and working with regulators
5+ years of experience and knowledge working with state level regulators and regulatory agencies
Quality management, project management, care management or utilization management experience
Solid legal research skills (i.e. Lexis/Nexis, NILS, Westlaw, etc.)
Proven knowledge of Mental Health Parity (MHPAEA) state & federal regulatory requirements
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyCalifornia, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $88,000 to $173,200 annually. 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.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.
