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VNS Health · 5 hours ago

Manager, Regulatory Affairs (Hybrid)

New York, NY

Full-time

Hybrid

Mid, Senior Level

$110K/yr - $146K/yr

4+ years exp

VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. The Manager of Regulatory Affairs oversees compliance and regulatory functions to ensure the organization's Medicaid and Medicare Advantage products meet federal and state regulations, while also serving as a subject matter expert and collaborating with various departments.

CharityHealth CareHome Health CareNon Profit

Responsibilities

Ensures compliance with requirements established by the New York State Department of Health (DOH), Office of the Medicaid Inspector General (OMIG), Centers for Medicare & Medicaid Services (CMS), and other bodies overseeing managed care organizations

Monitors and interprets applicable federal and New York State statutes, regulations, and guidance affecting managed care organizations. Assesses the impact of State and Federal regulatory changes on the enterprise’s programs and health insurance plans

Serves as Project Manager for regulatory affairs projects related to new or updated regulatory guidance. Acts as the liaison with business areas to ensure appropriate changes are made to the impacted departments. Develops monitoring processes to ensure implementation is effective and compliant

Provides guidance to lines of business on compliance risks, ensuring operational readiness and adherence. Ensures that communications regarding high-impact regulatory changes are provided to key operational and shared services stakeholders. Develops and provides training and education on new or updated regulatory requirements to Compliance and operations, as applicable

Manages regulatory filings, submissions, and reporting obligations, including oversight of corrective action plans (CAPs), routine compliance reports, and required attestations. Manages the process for the issuance, development, remediation, and validation of regulator-issued CAPs for identified and/or reported issues of non-compliance

Assists in the review, development, revision and maintenance of compliance policies and procedures

Acts as an interface between Compliance Operations and Regulatory Affairs teams with respect to clarification of regulatory guidance

Collaborates with the Quality department to ensure that regulatory mandates, certain certifications, and survey responses are being tracked and monitored

Maintains a regulatory reference library for use by the department

Assists in the preparation of updates and reports to management, Board of Directors, and Compliance Committee related to regulatory affairs and related compliance activities

Participates in special projects and performs other duties as assigned

Qualification

Healthcare complianceRegulatory affairsManaged care operationsMedicare regulationsNew York Medicaid regulationsProject managementAnalytical skillsWord proficiencyExcel proficiencyPowerPoint proficiencyLeadership skillsCommunication skillsTime managementProblem-solving skills

Required

Bachelor's Degree in healthcare administration, public health, business, law, or a health related field required

Minimum of four years of experience working in the health care industry, preferably with healthcare compliance, regulatory affairs, or managed care operations, with at least 3 years in a leadership or management role required

Strong knowledge of Medicare and New York State Medicaid managed care regulations and compliance requirements required

Demonstrated ability to research and interpret complex managed care regulations and communicate requirements effectively to operational teams. required

Proven capacity to work collaboratively across departments and build strong compliance partnerships required

Exceptional ability organizational, analytical, time management, project management and problem-solving skills required

Excellent written and verbal communication skills required

Fluent in Word, Excel, and Power Point required