Regulatory Adherence Coordinator

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

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.

Positions in this job function are responsible for submitting renewed BOP, DEA, City, State and other regulatory licenses to CMS to maintain Medicaid and Medicare pharmacy provider enrollments. In this role, you will ensure the timely submission of pharmacy license updates to state Medicaid agencies and to Medicare via the Provider Enrollment, Chain, and Ownership System (PECOS). You will also check revalidations date, complete changes of information, and handle other related inquiries associated with Medicaid and Medicare provider enrollments. Be responsible for pro-active and on-going contact with complex/matrixed state Medicaid agencies and Medicare Administrative Contractors (MACs). Methods and procedures fluctuate, are situational and may vary.

This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime.

This will be on the job training and the hours during training will be 8:00 am to 5:00 pm, Monday - Friday.

Primary Responsibilities:

• License Submission - Submitting updated licenses to state Medicaid agencies and Medicare MACs timely and accurately to maintain active enrollment status.
• Documentation - Maintain accurate records and documentation related to licenses and adhere to internal written procedures. Monitor and track status in internal tracking grid and system.
• Assess and prioritize workload appropriately to meet deadlines.
• Compliance Assurance - Conduct regular reviews of Medicaid and Medicare license requirement.
• Follow up with regulatory agencies which includes calling state Medicaid agencies and Medicare MACs.
• Training - providing training to new or existing employees.
• Serve as a subject matter expert regarding secondary filings requirements by state and NPI updates.
• Review and handle all applicable incoming emails and notices from CMS regarding pharmacy license updates.
• Resolves issues as able and communicates with manager on complex issues.
• Process improvements - maintain and enhance written job aids and provide recommendations.
• National Provider Identifier (NPI) - Process new application or changes of information request via the National Plan and Provider Enumeration System - NPPES.

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:

• High School Diploma or GED
• Must be 18 years of age or older

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Soft Skills:

• Applies knowledge/skills to activities that often vary from day to day.
• Demonstrates an advanced depth of knowledge and skills in own function.
• Requires minimal assistance with standard and non-standard requests.
• Sometimes acts as a technical resource to others in own function.
• Solves routine problems on own.
• Works with the team to solve more complex problems.
• Prioritizes and organizes own work to meet agreed upon deadlines.

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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