Healthcare Regulatory Affairs and Compliance Manager

Regulatory Affairs and Compliance ManagerThe Regulatory Affairs and Compliance Manager is responsible for ensuring the organizationremains compliant with the regulatory, licensing, and contractual requirements set forth bythe Centers for Medicare and Medicaid Services (CMS), the California Department of HealthCare Services (DHCS), and other regulatory agencies. The Regulatory Affairs andCompliance Manager performs regulatory compliance activities and implements monitoringinitiatives related to the Program of All-Inclusive Care for the Elderly (PACE).DUTIES / RESPONSIBILITIES : Monitors regulatory communications from CMS, DHCS, and other regulatoryagencies. Participates in conference calls and training webinars from regulatorsand / or associations. Reviews, analyzes, and interprets changes and / or updates toregulatory requirements to assess its impact to PACE operations and reporting.Communicates and disseminates guidance to internal departments, providesconsultation, and tracks implementation and appropriate training.Interacts with various departments to develop, review, and revise internal policiesand procedures and to verify compliance with regulatory, licensing, and contractualrequirements. Provides support for the Senior Health Services Policies andProcedures Committee. Manages the coordination, approval, and dissemination ofnew or revised policies and procedures.Assists with the coordination, tracking, and filing of routine and ad-hoc reports andfilings. Provides guidance to internal departments regarding reporting requirements.Reviews and quality checks data and information presented in reports prior tosubmission to CMS, DHCS, and other regulatory agencies as required.In coordination with supervisor, facilitates site visits from federal and stateregulators. Develops cross-departmental work plans for external regulatory audits.Manages the collection, review, and quality check of deliverables, including auditdata universes. Coordinates with internal departments in developing corrective actionplans in response to audit deficiencies and monitors status.Manages the monitoring of internal and external processes and functions to facilitatecompliance with the regulatory requirements. Assesses risks, identifies trends, andprepares reports. Gathers and reviews information and data for the regulatorycompliance dashboard. Presents results and recommendations for improvement tomanagement.Researches and analyzes regulatory compliance issues as they arise. In consultationwith supervisor, provides appropriate and timely guidance, outreach, andcommunication to internal departments.Oversees the maintenance and update to the regulatory compliance database forpolicies and procedures, regulatory communications, reports, filings, andaudit-related documentation.Provides leadership and direction to Regulatory Affairs and Compliance SpecialistsI / II, including recruitment, training, performance management, and evaluation.Performs other regulatory compliance activities and monitoring initiatives as assignedby supervisor.Collaborate with program operations and business intelligence to monitor PACE datauniverses, monitoring reports and ad-hoc reports as applicable.SUPERVISORY RESPONSIBILITIESManage the department's strategic and operational goals.Implement and communicate direction for goals, policies, and strategy forachievement.Motivate and lead department staff performance and escalate issues as necessary.Strategically and systemically handle staff development and performance.Anticipate challenges and put a strategy in place to resolve in a timely manner.Align department and employee actions, behaviors, and professional goals with theorganization's mission and goals.QUALIFICATIONS (knowledge, skills, abilities) : 1. Bachelor's degree in health care administration, business administration, or relatedfield from an accredited college.2. Excellent judgment with high integrity, flexibility, initiative, and willingness toparticipate in various regulatory activities and monitoring efforts.3. Excellent organizational, analytical, critical thinking, problem-solving, verbal, andwriting skills.4. Excellent time management and attention to detail.5. Ability to work well both independently and cross-departmentally in a matrixenvironment.6. Knowledge of pertinent regulatory requirements and / or guidelines from CMS andDHCS.7. Ability to read, analyze, and provide sound interpretation of rules, regulations, andguidelines.8. Ability to write clear, concise reports, summaries, business correspondence, andpolicies and procedures.9. Ability to effectively present and represent the organization's interest externally withauditors.10. Ability to effectively present information and respond to inquiries from employees,regulatory agencies, and others, as necessary.11. Proficient with MS Office (Word, Excel, and PowerPoint) and Adobe AcrobatProfessional.Employee Benefits include (eligible for any regular position for 20 hr / wk or more) : Medical, Dental, and Vision coverageRetirement Savings Plan 403(b) and Term Life / AD&D InsuranceFlexible Spending Account, Commuter Checks, MLA scholarships, EmployeeAssistance Program (EAP)Pet Insurance and additional discountsHolidays (10 per year), vacation time, sick leave, and long-term disability insurance