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Optum

Regulatory Affairs Consultant - Remote- PST

Posted 9 Days Ago
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In-Office or Remote
Hiring Remotely in Irvine, CA
92K-164K Annually
Senior level
In-Office or Remote
Hiring Remotely in Irvine, CA
92K-164K Annually
Senior level
Leads healthcare regulatory initiatives, compliance projects, audits, and stakeholder consultations. Interprets CMS, DMHC, DHCS, NCQA, and related requirements; coordinates responses to regulators; assesses risks; develops executive reporting; and drives process improvements across clinical and operational functions. Requires extensive healthcare regulatory or compliance experience, managed care knowledge, cross-functional project leadership, strong analytical and communication skills, and the ability to influence stakeholders in a changing environment.
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Requisition Number: 2378842
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
The Regulatory Affairs Consultant leads regulatory initiatives that support organizational strategy, compliance, and operational excellence. This role serves as a subject matter expert on healthcare regulatory requirements, providing guidance to stakeholders, managing regulatory projects, coordinating audits, and ensuring compliance with federal and state regulations, contractual obligations, and accreditation standards. Working closely with leadership and cross-functional teams, the consultant drives implementation of regulatory requirements and process improvements across the organization. Reports to the Vice President, DMHC Affairs Department.
If you are located in PST, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
  • Maintain expertise in current and emerging healthcare regulations, legislation, and industry requirements
  • Lead cross-functional efforts to assess, implement, and monitor regulatory initiatives, providing regular status updates and risk assessments
  • Contribute to regulatory engagement and operational strategies aligned with organizational goals
  • Translate complex regulatory and business requirements into clear, actionable guidance for diverse audiences
  • Provide regulatory interpretation and consultation to stakeholders; develop and manage work plans to support compliance objectives
  • Prepare and coordinate responses to health plans, regulatory agencies, and other external entities regarding regulatory inquiries and directives
  • Serve as the primary point of contact for regulatory audits and coordinate organizational participation
  • Ensure policies, procedures, and operational practices align with CMS, DMHC, DHCS, NCQA, and other applicable requirements
  • Analyze and resolve business challenges affecting clinical operations, workflows, and functional requirements
  • Develop reports, presentations, and executive-level communications on regulatory activities, risks, and compliance status
  • Identify opportunities for process improvement and recommend innovative, cost-effective solutions across departments
  • Perform additional duties and responsibilities 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:
  • 5+ years of experience in healthcare regulatory affairs, compliance, or related functions, including knowledge of managed care operations and industry trends
  • 3+ years of experience leading complex, cross-functional projects with aggressive timelines and multiple contributors
  • Experience managing multiple projects simultaneously and delivering successful outcomes
  • Solid knowledge of healthcare regulations and the ability to interpret requirements from CMS, DMHC, DHCS, and related regulatory bodies
  • Demonstrated success driving operational compliance and achieving regulatory objectives through collaboration and influence
  • Demonstrated solid relationship-building skills with the ability to lead change and gain stakeholder alignment
  • Demonstrated ability to navigate ambiguity, analyze complex issues, and develop practical solutions across functional areas
  • Demonstrated solid analytical, organizational, and problem-solving capabilities
  • Proven ability to manage multiple priorities in a fast-paced, evolving environment
  • Proven excellent verbal and written communication skills, including presenting to leadership and diverse stakeholder groups
  • Proven strategic thinker with the ability to translate organizational priorities into executable initiatives
  • Proven collaborative, adaptable, and results-oriented approach in dynamic, high-growth environments

*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 salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
OptumCare 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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