Regulatory Affairs Associate

Large and rapidly growing MLTC program with locations around NY, is currently seeking a Regulatory Affairs Associate to be responsible for the planning, development, direction, delivery, evaluation, and coordination of activities within their Regulatory Affairs Department. This key position will focus on regulatory compliance, contracts, provider relations, audits, investigations, and other related matters.

Regulatory Affairs Associate - Hybrid Role After Probationary Period

Hybrid - 2 to 3 days a week in the office and 2 to 3 days a week remote

Key Regulatory Affairs Responsibilities

• Review, draft, negotiate, and process agreements and amendments per organizational guidelines.
• Manage projects involving the collection and submission of data and information related to government audits, surveys, and requests.
• Handle provider contracting, including letters of agreement, and conduct follow-up.
• Review, disseminate, and handle FH notices; manage the FH calendar; conduct preparations for FHs and attend as needed.
• Review and handle communications and submit reports.
• Prepare status reports and updates on cases.
• Handle activities of the Special Investigation Unit (SIU), including reporting and internal investigations.
• Update applicable HIPAA policies and procedures in compliance with laws and regulations.
• Review OIG/OMIG requirements and best practices; update compliance materials, policies, and procedures to ensure adherence to regulations.
• Review and edit DOH and CMS plan contracts to ensure compliance with contract requirements.
• Review and disseminate CMS memos and DOH guidance, keeping up to date on laws and official guidance.
• Coordinate document requests from outside counsel for litigation matters.
• Maintain databases related to provider credentials and other essential information.
• Draft policies, procedures, manuals, and plan materials.
• Provide oversight and supervision of department staff.
  
  

Qualifications

• Minimum 3 years of experience in managed care contracting, credentialing, and compliance.
• Must currently possess a Juris Doctorate
• Strong knowledge of MLTC, MAP, Medicaid, and Medicare programs.
• Commensurate supervisory experience.
• Ability to review and analyze legal and commercial terms of agreements.
• Proficient in investigating incidents and recommending solutions.
• Highly skilled in organizational management, attention to detail, and multitasking.
• Excellent writing, editing, and proofreading skills.
  
  

Compensation:

• $150,000 - $180,000 annually
• Benefits include health insurance, retirement plans, paid time off, and professional development opportunities.