• Leads department efforts related to audit preparation, responses, and corrective action plans surrounding quality, Model of Care, and any other form of information requested from the team that could possibly have regulatory implications * Monitors changes in regulations and ensures the organization’s policies and procedures are updated * Ensures that Clinical Operations policies undergo annual review to include ensuring any required updates and approvals are complete, accurate, and timely * Oversees regulatory submissions and reports to agencies e.g. NYS DOH, CMS, etc. * Collaborates with stakeholders across the organization to establish timelines and obtain required information in support of regulatory actions * Oversees regulatory implementation efforts * Communicates with regulatory agencies and other external organizations * Ensures that Healthfirst meets requirements for all lines of business by developing requirements, documenting the activities that meet the requirements, and collaborating with stakeholders to close gaps as needed * Manages SNP Model of Care Committee which includes implementing and maintaining a committee structure, working with stakeholders to prepare for committee meetings, and managing committee membership * Develops and maintains departmental work plans and policies & procedures to ensure Healthfirst meets all regulatory requirements * Supervises the performance of direct reports and provides training and development opportunities; manages and holds team accountable for workload; conducts interviews, handles employee relations, and evaluates performance to develop a high functioning team * Additional duties as assigned or needed Minimum Qualifications: * Bachelors degree from an accredited institution or equivalent work experience * Experience leading/supporting regulatory activities/audits PreferredQualifications: * Masters degree from an accredited institution * Previous experience in managing staff and developing staff * Expertise reading and interpreting regulatory requirements for healthcare/managed care organizations * Expertise developing work plans and organizing work to execute against timelines * Work experience requiring effective communication with internal and external stakeholders in a variety of formats, both written (i.e., Word documents, Excel spreadsheets, PowerPoint presentations) and oral (i.e., conference calls, face-to-face meetings and presentations) Compliance & Regulatory Responsibilities: See Above License/Certification: N/A

Hiring Range*: * Greater New York City Area (NY, NJ, CT residents): $150,800 - $230,690 * All Other Locations (within approved locations): $124,400 - $190,315 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.