Manager, Regulatory Affairs

Role and Responsibility:
•Provide support to the organization and teammates in assessing, interpreting, and incorporating new and revised regulatory and government contract requirements
•Remain current and communicate federal/state laws and regulations, industry standards and best practices within the corresponding business area
•Oversee and manage the core regulatory functions such as implementing regulatory changes and submission deliverable management
•Report key statistics and trends of core regulatory functions to compliance leadership and company leadership for risk mitigation and improvement opportunities
•Oversee the process to address regulatory inquiries timely and accurately
•Ensure staff and leadership training of regulatory and government contracts requirements are completed within the timeframes outlined the Company’s Standards of Conduct
•Serve on designated external and internal committees to represent regulatory and contractual requirements
•Establish effective working relationships and build and maintain creditability within the organization to support a culture of compliance based on the Company’s core values
•Report potential risks, non-compliance or alleged violations to the Director, Corporate Compliance or Corporate Compliance Officer
•Identify performance improvement opportunities
•Provide management and oversight of professional staff
•Perform any other job related instructions as requested and other duties as assigned

Education / Experience:
•Bachelor’s degree or equivalent years of relevant work experience is required
•A minimum of five (5) years of experience in a healthcare related field or other highly regulated industry is required
•Previous management experience is preferred
•Process improvement or audit experience is preferred

Required Competencies / Knowledge / Skills:
•Skilled in collaborative management of professional staff
•Knowledge of standards or controls management, preferably from a Managed Care Organization
•Knowledge of regulatory environment and ability to interpret regulations
•Proven success in developing and implementing new practices and controls (with specific improvements)
•Experience in a high-growth business environment
•Working knowledge of health plan environment is preferred
•Strong analytical and statistical skills and attention to detail
•Ability to work in a fast-past environment and reprioritize
•Effective problem solving skills with attention to detail
•Ability to develop, prioritize and accomplish goals
•Strong communication skills, including high-level writing and editing skills, the ability to speak publicly and the ability to explain complex information in a meaningful way
•Strong interpersonal skills, a high level of professionalism and the ability to establish effective working relationships with key business partners
•Ability to work independently and within a team environment
•Effective active listening and critical thinking skills
•Display a customer service, member-focused orientation
•Proficient in Microsoft Word, Excel and PowerPoint
Licensure / Certification:

Working Conditions:

•General office environment; may be required to sit/stand for long periods of time

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