Optum in the tri-state region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group) offers an interconnected network that enables us to work collaboratively to better coordinate care among our doctors and care teams. Together, we offer you and your family access to more than 2,100 providers, representing 70 specialties, working in 360 medical practices and more than 55 urgent care locations across New York, New Jersey and Southern Connecticut.
We’re a dynamic and growing health care organization, offering a wide range of employment opportunities. We are seeking professional and dedicated individuals to be part of our team, where integrity, respect, accountability, and collaboration are among our core principles. Work with the largest care delivery organization in the world and start doing your life's best work.(sm)
We are seeking an experienced Clinical Compliance Specialist to join Optum PHNY Delivery (LCD) to assist in supporting the Clinic, Safety and Quality team, requiring up to 50% travel. Ideal candidates will have experience in a practice setting, as well as have compliance experience (preferably in healthcare operations compliance). Must have a full understanding of how a provider or clinic operates, in-depth knowledge of federal clinic health and safety standards (e.g., Joint Commission, AAAHC), audit experience and be comfortable supporting practice personnel and operations.
In this position you will be responsible for supporting all aspects of the practice, health and safety program.
- Interface with Local Care Delivery Organizations, Managers and clinic staff to conduct practice assessments and manage action plans through to complete resolution
- Oversee remediation and corrective action plans, resulting from internal assessments, audits, investigations, compliance reviews and self-identified issues
- Deliver targeted training, education and communications
- Provide subject matter expertise and tools to support compliance with applicable federal and state practice health and safety standards, with particular focus on clinical standards, compliance and regulatory requirements
- Objective, collaborative and professional approach
- Plans, directs and evaluates sites assessments
- Work alongside and offer assistance to registered nurses (RN), medical assistants (MAs) and licensed practical nurses (LPNs)
- Explains process of site assessments to employees to gain cooperation, understanding, and reduce apprehension
- Assists promptly with the implementation of remediation plans as needed
- Maintains the standards of accurate and complete recording and reporting
- Prepares and plans equipment needs prior to site assessments
- Participates in in-service training for personnel
- Supports, promotes and enforces infection control practices and standards
- Participates in quality improvement activities
- Communicates effectively with others
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.
- RN licensure in NY
- Experience with Microsoft Office 365 applications
- Valid driver’s license
- Ability to travel within region
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
- Experience in a regulatory and/or compliance role in healthcare operations; including:
- Audit experience with federal (e.g., Joint Commission, AAAHC) and state health and safety standards HIPAA and applicable state privacy laws Outstanding analytical
- Experience with TJC, AAAASF standards
- Knowledge of NYSDOH regulations
- Audit skills
- Organizational and problem-solving skills
- Exceptional written and verbal communication skills
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
CareMount Medical, ProHEALTH Care Associates, and Riverside Medical Group (the “Practices”) are all physician owned and led practices having complete authority for all medical decision-making and patient care through their physicians and other licensed professionals. Optum, through its management organizations (“Optum”) provides non-clinical administrative services to support the Practices and their physicians. Neither Optum nor its management companies employs, engages, or supervises physicians or other licensed professionals, or determines or sets the methods, standards, or conduct of the practice of medicine or health care provided by the Practices or by any of their licensed professionals. “Part of Optum” reflects that the Practices are part of Optum’s effort to support forward-thinking physician practices in helping their patients live healthier lives.
New York City Residents Only: The salary range for New York City residents is $56,300 to $110,400. 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.