Regulatory Affairs Consultant - DMHC Medical Survey Readiness - Remote

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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. The Regulatory Affairs Consultant, DMHC Medical Survey Readiness serves as the strategic lead for DMHC routine, follow-up, focused, and ad hoc medical surveys across Optum's four California licensed health plans. This role is accountable for developing and executing a comprehensive survey readiness program, providing expert regulatory guidance, directing health plan responses to regulatory reviews, and overseeing corrective action and remediation efforts to support compliance with California regulatory requirements. Reporting to the Director, DMHC Affairs, this position serves as the primary liaison between health plan leadership, operational stakeholders, and regulatory agencies on matters related to medical surveys and regulatory readiness. The consultant partners closely with Utilization Management, Quality Management, Network Management, Customer Service, Credentialing, Compliance, Clinical Operations, and executive leadership to ensure adherence to the Knox-Keene Health Care Service Plan Act, DMHC regulations, and health plan filing commitments. This role plays a critical part in identifying and mitigating regulatory risk, driving sustainable operational improvements, and strengthening organizational readiness in response to increasing DMHC oversight, scrutiny, and enforcement activities. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Lead DMHC medical survey readiness activities, ensuring ongoing preparedness for routine, focused, follow-up, and ad hoc surveys Serve as the central coordinator for DMHC medical surveys, regulatory reviews, and corrective action activities across Optum California licensed health plans Establish, implement, and maintain a comprehensive survey readiness program, including workplans, timelines, readiness assessments, document inventories, and issue tracking Coordinate the collection, review, validation, and submission of pre-onsite, onsite, and post-onsite survey documentation Conduct readiness assessments, gap analyses, mock audits, and document reviews utilizing DMHC Technical Assistance Guides (TAGs) and regulatory requirements Lead cross-functional survey meetings and drive accountability for readiness deliverables, corrective actions, and remediation activities Monitor regulatory developments, emerging enforcement trends, and DMHC guidance to assess operational impacts and survey readiness implications Identify, assess, and communicate regulatory risks associated with survey findings, operational processes, and evolving regulatory expectations Partner with business and operational leaders to implement corrective actions, mitigate regulatory risks, and drive sustainable process improvements Ensure consistency and standardization of survey readiness practices across all Optum California licensed health plans Track and report survey findings, deficiencies, corrective action plans (CAPs), remediation activities, and closure milestones Provide executive leadership with strategic reporting on survey readiness, regulatory risks, findings, corrective actions, and mitigation strategies Ensure policies, procedures, committee structures, and operational processes align with Knox-Keene requirements, DMHC regulations, and health plan commitments Coordinate and support regulator interviews, file reviews, entrance conferences, exit conferences, and other survey-related activities Establish and maintain regulatory evidence repositories and documentation controls to support