Director of Regulatory Affairs (Managed Care) Job in New York 10016, New York Us
- Provides leadership and coordinates resources, conducts trainings to ensure the ongoing effectiveness of the compliance program, which includes organizing and maintaining relevant files and preparing necessary reports on activities.
- Monitors compliance with laws, rules, and regulations, as well as ArchCare Advantage policies.
- Coordinates all aspects of site visits for Federal and State regulators.
- Researches regulations, remains current, inform various departments of regulations, and assist as needed in developing procedures to comply, as well as draft responses to queries by regulatory agencies.
- Coordinates the filing of regulatory forms, reports, etc. Assists other departments in understanding and complying with regulatory requirements to include researching regulations, informing departments of regulations, and assisting as needed in developing procedures to comply with, and draft responses to queries by regulatory agencies.
- Tracks all issues referred to the Regulatory Compliance Manager up to and including resolution.
- Tracks health plan performance relative to contract operational benchmarks.
- Provides analytics to senior management on proposed new and existing markets regarding regulatory considerations; contract requirements and pending legislative actions/bills, etc.
- Represents the health plan at federal, state, and local government meetings.Communicates the importance of compliance and the compliance program to health plan staff, which includes promoting an increased awareness of the Corporate Ethics and Compliance Program, an understanding of new and existing compliance issues and related policies and procedures, and the importance of internal compliance audits.
- A regulatory affairs manager must possess effective communication skills, time-management aptitude and the ability to understand complex problems and make proper decisions.
- Develops and maintains productive relationships with all levels of management as well as regulators and other relevant external parties.
- Provides education and training about laws and regulations that affect operations.
- Works with different functional areas to implement mandates, regulations, and corrective action plans, inclusive of corporate departments and local health plans.
- Performs special projects and audits.
- Functions as key plan representative/liaison with CMS, DOH, DOI, other Federal and State agencies and industry organizations regarding regulatory policy.
- Serves as key plan representative to receive, distribute, track and monitor all compliance correspondence, issues and updates received from CMS, DOH, DOI, other Federal and State agencies, HPMS.
- Strong interpersonal and communication skills.
- Clear, concise writing and presentation skills.
- Strong orientation to deadline and detail.
- Decisive and exercises good judgment under pressure.
- 5years industry related experience in healthcare compliance.
- Background in Medicare and Medicaid programs.
If interested, please apply online at http://track.tmpservice.com/ApplyClick.aspx?id=1307083-1789-4272
December 27, 2008
• Tags: Director of Regulatory Affairs (Managed Care) Job in New York 10016, New York Us • Posted in: General