Medicaid Regulatory Manager, NJ

Job Title: Medicaid Regulatory Manger, NJ
Department: Regulatory
Reports To: VP, Regulatory Affairs

Position Summary:
The Medicaid Regulatory Manager, NJ serves as the primary point of contact for State and local regulatory agencies with the responsibility to research, interpret and communicate regulatory requirements and new legislations that impacts the business. Responsible for ensuring and fostering an environment that enhances and promotes compliance, adherence to corporations ethical standards and conformance to all relevant State and local laws, rules and regulations applicable to the companys HMO and Medicaid contracts (Medicaid and NJ FamilyCare beneficiaries).
Essential Duties and Responsibilities:

Serves as the primary point of contact for State and local regulatory agencies, which includes both daily communication and scheduled site visits

Reviews and approves all marketing materials to ensure compliance and oversees the submission and communication of State and/or local approvals for these materials.

Researches, interprets and communicates regulatory requirements and new legislation that impact the business, as well as recommend and/or facilitate the required steps to effectuate necessary changes.

Submits applicable regulatory reports to State and/ or local agencies

Acts 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. Identifies potential risk areas and oversee the implementation and effectuation of plans of correction.

Participates on industry calls (government or industry sponsored) and/or attends relevant conferences/meetings and communicates pertinent information to management

Other Duties and Responsibilities:

Reviews and approves policies and procedures to ensure compliance requirements are met

Works with upper management to ensure training material is accurate and comports with current regulatory requirements.

Lead coordinator for external regulatory reviews

Works with impacted departments to ensure newly enacted requirements are implemented within mandated time frames.

Work Experience/Qualifications:
3-5 years of relevant experience with 1-3 years of supervisory/management experience.

Education Requirements:
Employee is required to possess a Bachelors Degree.
Physical Demands:
While performing the duties of this job, the employee is occasionally required to walk, bend, stand, drive and constantly sit and key.

Work Environment:
While performing the duties of this job, the employee constantly works in an indoor environment.

Additional Information:
An important skill set with this job is the ability to build relationships with other departments and external customers. A compliance manager must be organized and capable of multi-tasking various projects at different levels or competing priorities. The candidate must also be able to prioritize their scope of work in line with the Companys organizational goals.
Conditions of Employment: Employee must pass pre-employment screening which includes a background check and drug testing. Employee must present documentation to verify minimum of high school educational requirement.
Disclaimer: The statements herein are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
All qualified applicants will receive consideration for employment withoutregard to age, race, color, religion, sex, national origin, disability or veteran  Requirements3-5 years of relevant experience with 1-3 years of supervisory/management experience.


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Country: USA, State: New York, City: Ny, Company: Healthfirst.