Michael Jurmu
Shawano,WI
Summary
Diversely-experienced compliance professional bringing more than 15 years of compliance expertise and increasing accountabilities within Fortune 100 Health Services companies. History of supporting a wide array of products within a highly-regulated environment. Strategic thinker with an aptitude for program implementation and oversight. A lifelong learner looking for a new area to learn.
Overview
14
14
years of professional experience
Work History
Director of Program Integrity Compliance
United Healthcare
Green Bay, WI
10.2019 - Current
- Maintained the organizational Program Integrity Oversight Committee, Anti-Fraud Compliance Program Document and related policies
- Provided compliance support for various investigative and data analytics teams delivering fraud, waste and abuse services.
Associate Director of Investigations
United Healthcare
Green Bay, WI
01.2017 - 10.2019
- Set strategy for, and supported, all non-investigations activities, to include regulatory interactions, across Medicaid, Medicare and Commercial lines of business
- Acted as primary liaison between the investigations team and compliance program.
Associate Director of Compliance
United Healthcare
Green Bay, WI
03.2014 - 10.2016
- Supported the Compliance Officer in administration of the Compliance Program for a Department of Defense TRICARE contractor (UHC Military & Veterans)
- Provided oversight of risk assessments, ethics investigations, communication plans, policy maintenance and compliance committee reporting
- Supported transition out of a government contract.
Compliance Manager
United Healthcare
Green Bay, WI
01.2013 - 03.2014
- Managed a team conducting internal audits and supporting external stakeholder audits and visits
- Designed and implemented a Compliance Risk Assessment process
- Supported transition into the organization's first Department of Defense TRICARE contract.
Compliance Consultant
United Healthcare
Green Bay, WI
01.2010 - 12.2012
- Member of a team of five acting as primary contact for Centers for Medicare & Medicaid Services (CMS) inquiries and concerns
- Investigated issues and timely provided updates to the regulator while driving resolution
- Maintained a positive relationship with regulatory counterparts, built upon trust and respect.
Education
Juris Doctor -
University of Illinois
Bachelor of Arts in Journalism -
Michigan State University
Certification -
Introduction to Artificial Intelligence
Certification -
Data Ethics: Managing Your Private Customer Data
Skills
- CMS Program Audit Support
- Supervision & Leadership
- Internal Audit and Monitoring
- LEXIS
- SERFF
- Regulatory Audit Management
- Microsoft Office
- Microsoft Teams
- HIPAA
- Appeals and Grievance
- Corrective Action Plans
- Medicare
- Medicaid
- Writing & Publishing
- Training & Development
- Data Analysis
- Legal Analysis
- Manual and Electronic Legal Research
- Investigative Skills
- Regulatory Implementation
- Mental Health Parity Analysis
- Medicare Risk Adjustment
- Seven-Element Compliance Program Implementation
- Oversight Committee Implementation
- Federal Acquisition Regulation (FAR)
- Policy Drafting, Implementation and Maintenance
Timeline
Director of Program Integrity Compliance
United Healthcare
10.2019 - Current
Associate Director of Investigations
United Healthcare
01.2017 - 10.2019
Associate Director of Compliance
United Healthcare
03.2014 - 10.2016
Compliance Manager
United Healthcare
01.2013 - 03.2014
Compliance Consultant
United Healthcare
01.2010 - 12.2012
Juris Doctor -
University of Illinois
Bachelor of Arts in Journalism -
Michigan State University
Certification -
Introduction to Artificial Intelligence
Certification -
Data Ethics: Managing Your Private Customer Data