A healthcare organization in New York City is seeking a Director of Regulatory Compliance Operations to lead regulatory approvals, submissions, and compliance with all regulatory guidelines. This role ensures alignment with applicable requirements across all lines of business through oversight of regulatory communications and policy processes.
*This is a remote role with minimal office time as needed.
Responsibilities:
The Director of Regulatory Compliance Operations will be responsible for:
- Contributing to the annual risk assessment plan with Compliance teams to identify potential compliance issues across the organization
- Overseeing the Regulatory Compliance Operations unit in managing regulatory submissions and the Policy and Procedure Program
- Preparing and updating materials for compliance committees, including the Compliance Committee and the Board's Audit and Compliance Committee
- Serving as the regulatory expert to ensure marketing practices align with regulatory guidelines
- Acting as the primary liaison and managing correspondence with regulatory agencies for Plan submissions, including handling complex regulatory queries and advisory comments
- Proposing effective, compliant regulatory strategies to support business objectives and reduce regulatory risk
- Providing regulatory consultation for the development and execution of marketing strategies and promotional programs
- Reviewing concepts and draft materials to ensure regulatory alignment
- Keeping abreast of evolving regulations, advisory letters, and policy updates impacting managed care organizations
- Continuously assessing departmental effectiveness, including people, processes, and technologies, to achieve corporate goals
- Identifying improvement opportunities and generating solutions to enhance performance metrics
- Leading complex projects and providing regulatory training and coaching for team members
- Assisting the Vice President of Compliance with additional tasks as needed
Qualifications:
- Bachelor's Degree
- 5+ years in managed care compliance or regulatory department with in-depth knowledge of managed care health plan regulations
- 2-3+ years of staff management experience, with a proven ability to coach and mentor
- Experience with New York State managed care products is strongly preferred
- Comprehensive knowledge of health law, managed regulation, and healthcare compliance programs
- Familiarity with business administration, HR management principles, and healthcare organization standards
Desired Skills:
- Master's in Healthcare or Communications
- Relevant certifications
- In-depth understanding of NY State managed care regulations
- Strong leadership and team-building skills
