Remote Health Regulatory Affairs Consultant

UnitedHealth Group; Irvine (CA); Remote; Confidential; Full time

Job summary

UnitedHealth Group via OptumCare seeks a Regulatory Affairs Consultant to lead regulatory initiatives that support strategy, compliance, and operational excellence across the organization. You will serve as a subject matter expert on healthcare regulatory requirements and guide cross-functional teams to drive process improvements.

The role focuses on interpreting CMS/DMHC/DHCS/NCQA requirements, coordinating audits, and coordinating responses to regulatory inquiries while partnering with

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.

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.

Skills

Regulatory affairs

Cross-functional leadership

Regulatory compliance

Analytical thinking

Stakeholder management

Project management

Communication skills

Ambiguity navigation

Job description

UnitedHealth Group via OptumCare seeks a Regulatory Affairs Consultant to lead regulatory initiatives that support strategy, compliance, and operational excellence across the organization. You will serve as a subject matter expert on healthcare regulatory requirements and guide cross-functional teams to drive process improvements.

The role focuses on interpreting CMS/DMHC/DHCS/NCQA requirements, coordinating audits, and coordinating responses to regulatory inquiries while partnering with