Regulatory Affairs Associate - Managed Long Term Care (...

Company InformationOur client's Health Plan proudly serves over 18,000 frail individuals, supporting their ability to live independently at home for as long as possible. Join our compassionate, dedicated team and help make a meaningful difference in the lives of those they serve!Opportunity DescriptionOur client is seeking a Regulatory Affairs Associate to be responsible for the planning, development, direction, delivery, evaluation, and coordination of activities within our Regulatory Affairs Department. This key position will focus on regulatory compliance, contracts, provider relations, audits, investigations, and other related matters.Job DutiesContracts and AgreementsReview, draft, negotiate, and process agreements and amendments per organizational guidelines.Audit and Survey ManagementManage projects involving the collection and submission of data and information related to government audits, surveys, and requests.Provider Relations and ContractingHandle provider contracting, including letters of agreement, and conduct follow-up.Fair Hearing (FH) ManagementReview, disseminate, and handle FH notices; manage the FH calendar; conduct preparations for FHs and attend as needed.Review and handle communications and submit reports.Prepare status reports and updates on cases.Special InvestigationsHandle activities of the Special Investigation Unit (SIU), including reporting and internal investigations.HIPAA ComplianceUpdate applicable HIPAA policies and procedures in compliance with laws and regulations.OIG/OMIG ComplianceReview OIG/OMIG requirements and best practices; update compliance materials, policies, and procedures to ensure adherence to regulations.DOH and CMS ContractsReview and edit DOH and CMS plan contracts to ensure compliance with contract requirements.Regulatory GuidanceReview and disseminate CMS memos and DOH guidance, keeping up to date on laws and official guidance.Litigation and Legal RequestsCoordinate document requests from outside counsel for litigation matters.Database ManagementMaintain databases related to provider credentials and other essential information.Policy DevelopmentDraft policies, procedures, manuals, and plan materials.Team OversightProvide oversight and supervision of department staff.Experience & Skills RequiredJuris Doctorate RequiredMinimum 3 years of experience in managed care contracting, credentialing, and compliance.Strong knowledge of MLTC, MAP, Medicaid, and Medicare programs.Commensurate supervisory experience.Ability to review and analyze legal and commercial terms of agreements.Proficient in investigating incidents and recommending solutions.Highly skilled in organizational management, attention to detail, and multitasking.Excellent writing, editing, and proofreading skills.Other InformationOrganization: Our client is a prestigious long-term care organization in North Bronx.Location: North Bronx, NYSchedule: Monday to Friday, OnsiteSalary$150,000 - $165,000 annuallyBenefits: Our client offers a comprehensive benefits package, including health insurance, retirement plans, paid time off, and opportunities for professional development.

Created: 2025-09-26