What are the responsibilities and job description for the Regulatory Affairs Associate position at HumanEdge?
Opportunity Description
Our client serves over 16,000 frail individuals and helps them live in their homes and independently for as long as possible. Join our compassionate and dedicated team and make a difference in the lives of our members at the Health Plan. The Director of Regulatory Affairs will be responsible for The Director of Regulatory Affairs will be responsible for directing, delivering, evaluating, and coordinating activities of the Regulatory Affairs Department.
Responsibilities:
The Director in collaboration with senior management will be responsible to:
- Review, negotiate, draft and process agreements and amendments in accordance with regulatory requirements and plan protocols.
- Manage submission of delegated agreements and required documents for government approval and track status.
- Set up protocols for contract organization and keep track of contract status.
- Prepare and submit regulatory reports.
- Direct and organize provider communications related to audits, surveys, requests and attestations.
- Review OIG and OMIG requirements and best practices for compliance program.
- Review and update compliance materials, including manuals, policies and procedures, handbooks, to comply with regulatory requirements.
- Read and disseminate CMS and DOH memos, guidance and alerts.
- Provide oversight and supervision of the Department’s staff.
Qualifications:
- Juris Doctor and minimum 5 years’ experience, with emphasis in managed care contracting, credentialing and compliance.
- Commensurate supervisory experience required.
- Ability to respond to inquiries or complaints from members, providers, regulatory agencies, staff or members of the business community.
- Ability to direct and manage projects to completion.
- Ability to effectively present information to top management, department heads, and/or boards of directors.
Salary : $160,000 - $180,000
