Regulatory Affairs Consultant - Remote- PST

Posted Yesterday
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Hiring Remotely in Irvine, CA, USA
In-Office or Remote
92K-164K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
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.
Summary Generated by Built In
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.

Skills Required

  • 5+ years of experience in healthcare regulatory affairs, compliance, or related functions
  • 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 ability to interpret CMS, DMHC, DHCS, and related requirements
  • Experience driving operational compliance and achieving regulatory objectives through collaboration and influence
  • Strong relationship-building skills and ability to lead change and gain stakeholder alignment
  • Ability to navigate ambiguity, analyze complex issues, and develop practical solutions across functional areas
  • Strong analytical, organizational, and problem-solving capabilities
  • Excellent verbal and written communication skills, including presenting to leadership and diverse stakeholder groups
  • Strategic thinking and ability to translate organizational priorities into executable initiatives
  • Collaborative, adaptable, and results-oriented approach in dynamic, high-growth environments

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Parental & Family Support Paid parental leave (six weeks), paid caregiver leave (up to two weeks), Bright Horizons back-up care, and adoption assistance up to $10,000 are prominently included. Feedback suggests these family supports meaningfully aid work-life balance and are often highlighted as strengths.
  • Retirement Support A 401(k) with company match is available to all employees, including part-time staff, alongside other financial protections like disability and life insurance. Feedback suggests broad access and matching make retirement support a core pillar of the package.
  • Equity Value & Accessibility An Employee Stock Purchase Plan offers discounted company stock, with some roles also eligible for sign-on or performance bonuses. Feedback suggests the ESPP is a standout financial perk that helps employees build ownership over time.

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, 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. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
Cebu, Philippines
Davao, Philippines
Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
Chennai, India
Dallas, TX
Detroit, MI
Dublin, Ireland
Hartford, CT
Houston, TX
Hyderabad, India
Jacksonville, FL
Las Vegas, NV
Letterkenny, Ireland
Louisville, KY
Madison, WI
Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
Phoenix, AZ
Pune, India
Raleigh, NC
San Diego, CA
Washington, DC
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