Regulatory Guidance Manager NYC

Job Description

Job Description

The Regulatory Guidance Manager is responsible for overseeing a team of analysts and ensuring regulatory compliance by disseminating guidance to affected business units. The position will develop and maintain relationships with regulatory agencies and stay up to date on any changes or updates to regulations. The position is accountable for supporting the Director of State Regulatory Guidance and will provide, as well as oversee, the provision of guidance to staff and for conducting regulatory research and analysis to identify and interpret regulatory requirements and trends. The position will be responsible for overseeing a team of analysts with expertise in different lines of business to ensure optimal performance of the department.

Job Description

• Oversee a team of regulatory analysts to ensure timely dissemination of accurate guidance for applicable laws and regulations related to all NYS regulated Lines of Business (LOBs) that the Plan offers.
• Develop and coordinate with the Project Management Team (PMO) and the Product Team on workplans to implement new regulatory changes.
• Provide guidance and conduct regulatory research and analysis to help identify and interpret requirements and trends.
• Evaluate the impact of regulatory changes on the organization and advise plan leadership on necessary actions.
• Develop and maintain relationships with regulatory agencies and stay up-to-date on any changes or updates to regulations.
• Participate in stakeholder calls and create summaries of calls for dissemination to senior staff.
• Work with the Regulatory Operations team to manage the preparation and submission of regulatory filings, reports, and documentation.
• Identify and assess potential regulatory risks and develop strategies to mitigate those risks.
• Collaborate with cross-functional teams to ensure compliance across all areas of the organization.
• Participate in high-level implementations of carve-in/carve-out services; program services such as changing vendors or adding new vendors.
• Participate in various external audits/surveys such as the Article-44 Operational Survey to ensure compliance with state regulations. Upload all requested information into the Health Commerce System (HCS), the state’s database, as necessary.
• Supervise a team of Regulatory Specialists assigning tasks and projects and conducting performance evaluations. Ensure that the team is adequately trained and equipped to perform their duties, including identifying and addressing knowledge and skill gaps and that staff are up to date with work assignments and provide guidance as needed. Provide feedback to staff to help improve their productivity, efficiencies and growth.
• Other duties as assigned by the Director, Senior Director or Chief Compliance & Regulatory Officer.

Requirements

• Bachelor's degree required; and
• 5+ years of Regulatory Affairs work experience; or
• A satisfactory equivalent combination of education, training, and experience in other Managed Care operational departments.
• Experience with managing and leading teams.
• Master’s degree or Juris Doctorate preferred.
• Experience with NY State managed care products strongly preferred.
• Strong knowledge of healthcare laws and regulations, including HIPPA, Medicare and Medicaid.
• Proficient MS Word, Excel, SharePoint and PowerPoint required.