Director of Regulatory Compliance Operations

$150,000 - $165,000/Yr

Metroplus Health Plan - New York, NY

Full-time - Senior

New York, NY

Professional, Scientific, and Technical Services

About the position

The Director of Regulatory Compliance Operations is responsible for overseeing regulatory approval processes, submissions, and the development of policies and procedures within MetroPlusHealth. This role ensures that all communications and submissions to regulatory agencies comply with applicable requirements across various lines of business, while also contributing to risk assessments and providing regulatory consultation for marketing strategies.

Responsibilities

• Oversee the Regulatory Compliance Operations unit and manage regulatory and material submissions.
• Contribute to the annual Plan risk assessment in collaboration with various Compliance teams.
• Prepare and update materials for compliance committees, including the Compliance Committee and Audit and Compliance Committee of the Board of Directors.
• Serve as the regulatory expert to ensure marketing practices align with regulatory guidelines.
• Manage correspondence with regulators regarding Plan submissions and complex regulatory questions.
• Propose compliant regulatory strategies and solutions that meet business objectives and minimize risk.
• Provide regulatory consultation for the development and implementation of marketing strategies and promotional programs.
• Maintain awareness of evolving regulations and policy issues impacting managed care organizations.
• Assess departmental effectiveness and identify opportunities for improvement.
• Provide regulatory training and coaching to team members.

Requirements

• Bachelor's Degree required; Master's in Health Care or Communications preferred.
• Minimum five years of experience in managed care compliance or regulatory department with detailed knowledge of rules governing managed care health plans.
• 2-3 years of experience managing staff with demonstrated ability to coach and mentor.
• Experience with NY State managed care products strongly preferred.
• Thorough knowledge of health law, policy, and compliance programs applicable to health plan operations.
• Knowledge of business and human resources administration principles.

Nice-to-haves

• Experience building relationships across business groups internally and externally.

Benefits

• Competitive salary range of $150,000.00 - $165,000.00
• Full-time employment with a commitment to community health.
• Opportunities for professional development and training.