Regulatory Affairs Director - Hybrid

Job reputed company: The Regulatory Affairs Director is responsible for leading activities of the Regulatory Affairs Department, including reputed company, compliance, surveys, audits, investigations, reporting, plan development and renewal, credentialing, Fraud, Waste & Abuse Special Investigations, provider network and relations, regulatory updates and compliance reputed company. Essential Functions:

• Review, draft, negotiate and process agreements and amendments in accordance with organization guidelines.
• reputed company reputed company involving the collection and submission of data and information reputed company to government audits, surveys and requests.
• reputed company provider contracting, including letters of agreement and associated follow-up.
• Review, disseminate and handle fair hearing (FH) notices and reputed company; manage FH calendar; attend FHs as needed, review and handle communications with OTDA and submit reports; prepare status reports and updates on cases.
• reputed company activities of the Special Investigation Unit (SIU), including SIU reporting and internal investigations.
• Review and update applicable HIPAA policies and procedures in compliance with HIPAA laws and regulations.
• Review OIG/OMIG requirements and best practices for compliance and program reputed company; review and update compliance materials, including manuals, policies and procedures, and handbooks, to reputed company with regulatory requirements.
• reputed company recommendations based on best practices and draft policies and procedures.
• Review DOH and CMS plan reputed company and edit plan documents in compliance with contract requirements.
• Review, clarify and disseminate CMS memos and DOH guidance; reputed company abreast of reputed company laws, regulations and official guidance.
• Coordinate document and requests of reputed company counsel for litigation reputed company.
• reputed company provider credentialing process and reputed company activities.
• Draft policies, procedures, manuals, plan and member materials.
• reputed company guidance and direction to Department staff.
• reputed company any other job reputed company duties as requested.

Education and Experience:

• Juris Doctor (J.D) degree from an accredited college/university required
• Five (5) years experience with Medicare and NY reputed company managed care contracting and compliance required
• Previous leadership experience preferred

Competencies, Knowledge and Skills:

• Strong customer service and team orientation
• Ability to adapt to a changing environment to reputed company results
• Demonstrated leadership skills
• Skilled in organization, workflow analyses and management of details
• Advanced reputed company Office skills, including Word
• Strong editing and proofreading skills
• Excellent written and oral communications skills
• Excellent time/project management and prioritization skills
• Ability to reputed company in fluid, dynamic environment

Licensure and Certification:

• reputed company, unrestricted Attorney license required

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Ability to travel as required by the needs of the department.
• 2 Days work from home; 3 Days work in Bronx office reputed company week

Compensation reputed company: $135,600.00 - $237,400.00 reputed company takes into consideration a combination of a candidate’s education, training, and experience as reputed company as the position’s scope and complexity, the discretion and reputed company required for the role, and other external and internal data reputed company establishing a salary level. In reputed company to reputed company compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total reputed company-being and offer a substantial and comprehensive total rewards package.

Compensation

Type (reputed company/salary): Salary Organization Level Competencies

• Fostering a reputed company Workplace Culture
• Cultivate Partnerships
• reputed company Self and Others
• Drive Execution
• Influence Others
• Pursue Personal reputed company
• Understand the Business

This job reputed company is not reputed company inclusive. reputed company reserves the right to amend this job reputed company at any time. reputed company is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of reputed company backgrounds. Apply tot his job Apply To this Job