Jobs at United Healthcare – Compliance Lead

Job Description:

Leads cross-functional support, development, and execution of Surest’s Pharmacy benefit solutions to ensure compliance and regulatory standards are upheld. Responsible for establishing strategies, negotiating relationships with key compliance partners, and serving as the subject matter expert for both internal and external audiences in support of Surest’s Pharmacy benefit solutions.

Job Responsibilities:

• Analyzes and reviews market or customer experience, utilization, and related information on an ongoing to as needed basis to determine trends, draw conclusions, interpret findings, and presents results, proposals, and recommendations to pharmacy, benefit design and market leaders


• Develops and applies department policies and procedures and assists with applicable laws, rules, and regulations; ensures compliance and receives guidance within these areas as needed


• Strategizes and maintains overall compliance standards with Surest’s PBM market portfolio; including developing a compliance playbook to drive scalability with Surest’s PBM partners. This includes both Fully Insured and ASO clients


• Provides feedback and guidance to resolve management and customer questions and requirements; assists with receiving customer feedback and coordinating resources and responses as required


• Partners with UHC and Surest’s Compliance teams to ensure Surest’s Pharmacy benefit solutions meet industry standards


• Develops project plans, timelines, and requirements for any compliance driven State or Federal guidelines that impact Surest’s PBM portfolio


• Assists with developing operations or cross-functional project or program objectives, which includes proposed budgets, timelines, materials, personnel, and other project requirements

Job Requirements:

• Possesses the ability to take on more complex tasks and responsibilities


• Proven ability to take initiative, effects change, and influences both internal and external team members to drive progress


• Solid project management skills, proven ability to facilitate large, multidisciplinary teams, and establish workflows from the ground up


• Proven ability to convey status in both written and verbal communication and tailor communication according to audience


• Proficient in MS Office Suite (PowerPoint, Word, Excel, MS Project)


• Able to deliver executive presentations to internal and external stakeholders communicating status, issues, risks, and mitigation recommendations

Qualification & Experience:

• Technical experience (proficiency) with HIPPA standard data transactions


• 7+ years of project management experience, ideally in a clinical or payer setting; preferably PBM space


• 5+ years of experience with State and Federal mandates that impact the PBM industry

Job Details:

Company: United HealthCare

Vacancy Type: Full Time

Job Location: Minneapolis, MN, US

Application Deadline: N/A

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