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MLTC Regulatory Affairs Associate

Bronx, NY

Posted: 03/19/2024 Industry: Healthcare Job Number: 37349 Compensation: 125,000

Job Description

Role Overview:
Our client, a leading managed care organization serving over 16,000 individuals, is seeking a Regulatory Affairs Associate to oversee regulatory compliance activities. In this role, you will plan, develop, and coordinate the Regulatory Affairs Department's efforts to ensure adherence to federal and state guidelines while supporting our mission of helping members live independently.

Compensation: $125,000.00 - $150,000.00
Location: Bronx, New York
Schedule: Monday - Friday, day hours

•    Review, draft, negotiate, and process agreements and amendments
•    Manage projects related to government audits, surveys, and data requests
•    Handle provider contracting, including letters of agreement and follow-up
•    Oversee fair hearing processes, notices, reports, and communications
•    Coordinate Special Investigation Unit (SIU) activities and internal investigations
•    Update HIPAA policies and procedures to ensure regulatory compliance
•    Review and update compliance materials based on OIG/OMIG requirements
•    Ensure plan documents align with DOH and CMS contract requirements
•    Monitor and disseminate relevant laws, regulations, and guidance
•    Liaise with outside counsel on litigation matters
•    Maintain provider credential and information databases
•    Draft policies, procedures, manuals, and plan materials
•    Provide supervision and oversight to department staff

•    Juris Doctor (JD) degree required
•    Minimum 3 years experience in managed care contracting, credentialing, and compliance
•    In-depth knowledge of MLTC, MAP, Medicaid, and Medicare regulations
•    Commensurate supervisory experience required
•    Strong contract review and negotiation skills
•    Ability to conduct incident investigations and recommend solutions
•    Excellent organizational, writing, editing, and proofreading abilities
•    Meticulous attention to detail and project management skills
•    Proficiency in Microsoft Office and database management

Some of the common benefits offered by the health institutes we represent include:
•    Healthcare Benefits
•    Retirement Plans
•    Paid Time Off (PTO)
•    Professional Development
•    Bonuses and Incentives

Application Notice: Qualified candidates will be contacted within two business days of application. If an applicant does not meet the above criteria, TAG MedStaffing will keep your resume on file for future opportunities and may contact you for further discussion.
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