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_Hybrid work schedule consists of reporting to our 100 Church Street, NYC office 3 days per week._

Scope of Responsibilities** **:

In this role, you will:

+ Be responsible for supporting the Long-Term Care lines of business strategy and execution.

+ Be knowledgeable in Long-Term Care products, including but not limited to the Partial Capitation Managed Long-Term Care plan, the Medicaid Advantage Plus (MAP) and/or Program of Complete Care for the Elderly (PACE) products.

+ Work with the appropriate business areas to ensure that strategic, operational, and tactical business plans for new products are achieved in accordance with CMS and the NYSDOH requirements.

+ Assist the appropriate business areas, including Regulatory Change Management, to implement special projects, initiatives, and activities to support line of business objectives, product, benefit administration, process improvement, efficiency, and customer experience in accordance with CMS and NYSDOH requirements.

+ Develop & maintain relationships across the enterprise to promote consistent strategic priorities.

+ Serve as a regulatory liaison to CMS, NYSDOH, or other regulatory agencies as needed.

+ Represent the Regulatory Affairs department on related key cross-functional committees and projects to ensure MLTC perspective is being integrated into strategies of other areas.

+ Read, interpret, and identify necessary next steps related to complex government regulations.

+ Collaborate with the Healthfirst Compliance department, oversees the implementation and effectuation of all plans of correction developed for both internal and external audits.

+ Act as a consultant to internal departments regarding regulatory issues while understanding the underlying root cause and applicable regulatory requirements, conducts analysis of risk, and recommends or initiates necessary corrective action.

+ Review & approve policies and procedures, and marketing materials as well as submit reporting requirements to CMS/NYSDOH to ensure regulatory requirements are met.

+ Be responsible for bringing pertinent items to Healthfirst Regulatory Change Management and seeing projects through to fruition to ensure all associated deadlines are met.

+ Work in collaboration with the Regulatory Audit Manager on all external agency audits/site visits.

**Minimum Qualifications** :

+ Bachelors degree from an accredited institution or equivalent work experience.

+ Strong leadership and/or management experience in Managed Long-Term Care programs compliance or regulatory program at a health plan, provider, law firm, state regulatory agency or consulting firm.

+ Strong expertise and background dealing with regulatory agencies such as CMS, NYSDOH, etc.

+ Strong process and program management skills, analytical, creativity and initiative in problem solving and solution identification.

+ Must be capable of establishing effective relationships with all levels of representation throughout the organization.

+ Strong facilitation skills and follow-through.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.