Job Details

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Manager External Audit will oversee and manage audits and market conduct examinations conducted by state regulatory agencies across OptumRx's commercial business. This individual will be responsible for all aspects of audit preparation, strategy and defense activities and plays a critical role in facilitating the organization's timely and accurate response to regulatory oversight.

OptumRx is an innovative pharmacy benefit management organization managing the prescription drug benefits of commercial, Medicare and other governmental health plans, as well as those of employers and unions. Services offered by the company include pharmacy network contracting, rebate contracting and administration, mail order pharmacy facilities, specialty drugs and retail drug claims processing. OptumRx is part of Optum, a leading information and technology-enabled health services business dedicated to making the health system work better for everyone.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities :

• Lead the preparation, coordination, and submission of responses to regulatory audit/market conduct examination (MCE) requests and findings, ensuring timely and accurate completion of all audit-related documentation and communication

• Serve as the primary point of contact for regulatory agencies during the audit process. Maintain effective communication with internal stakeholders to keep them informed of audit status and resolutions

• Partner with the business and colleagues across legal, compliance and regulatory affairs to successfully resolve audits, including development of appropriate corrective action plans

• Support root cause analysis of confirmed audit findings in coordination with business teams

• Maintain detailed records of audit responses, corrective actions, and resolutions. Prepare and present reports on audit outcomes and compliance status to External Audit leadership

• Identify opportunities to improve audit processes and support the execution of best practices to enhance overall audit efficiency and effectiveness

• Cultivate and maintain solid collaborative relationships with regulators and OptumRx business partners

• Provide ongoing education and training to the business on best practices in MCEs

• Assist with various projects as directed by External Audit leadership

• Participate in occasional business travel to meet with regulators and business teams

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:

• Education : Bachelor's degree or equivalent professional experience

• Experience :

• 3+ years of experience conducting Market Conduct examinations or working with state Departments of Insurance (DOI), including audits, surveys, and investigations

• 3+ years in internal audit (operational, financial, or IT)

• 3+ years in a healthcare regulatory or compliance environment

• Demonstrated knowledge of HIPAA and state-specific privacy regulations

• Skills :

• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)

• Proven solid project management capabilities

• Proven effective communication and collaboration with external regulators and auditors

• Proven adaptability to fast-paced environments and shifting priorities

• Willing or ability to manage multiple concurrent audits while meeting productivity and quality standards

Preferred Qualifications:

• Education : Master's degree

• Experience :

• Project management and team leadership experience

• Background in pharmacy or pharmacy benefits management (PBM) industries

• Proven success in developing and implementing enterprise-wide compliance programs

• Skills :

• Deep understanding of regulatory frameworks and audit methodologies

• Proven exceptional written, verbal, and interpersonal communication skills

• Proven advanced analytical, organizational, and problem-solving abilities

*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 $89,900 to $160,600 annually 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.