Plans efforts to ensure compliance with the laws, regulations, and policies that govern its Medicare and Medicaid business. Performs research, complies reports, coordinates filings, and conducts special projects for key regulatory projects, updates and/or changes.
Reports to: Director, State Regulatory Affairs
Location: Lincoln, NE
- Coordinates resources to ensure the ongoing effectiveness of the compliance program, which includes organizing and maintaining relevant files and preparing necessary reports on activities.
- Supports regulatory analysis, including the review, summarization and dissemination of key regulatory updates and changes.
- Conducts independent research on assigned projects and collaborates and coordinates with other other departments on information needs.
- Monitors compliance with laws, rules, and regulations, as well as Health Plan policy.
- Researches regulations, inform various departments of regulations, and assist as needed in developing procedures to comply, as well as draft responses to queries by regulatory agencies.
- Coordinates the filing of regulatory forms, reports, etc. Assists other departments in understanding and complying with regulatory requirements to include researching regulations, informing departments of regulations, and assisting as needed in developing procedures to comply with, and draft responses to queries by regulatory agencies.
- Tracks all issues referred to the Regulatory Affairs Department up to and including resolution.
- Develops and maintains productive relationships with all levels of management as well as regulators and other relevant external parties.
- Supports the design and implementation of databases to ensure key departmental processes are captured in the database for tracking and trending purposes.
- Works with different functional areas to implement mandates, regulations, and corrective action plans.
- Performs other projects as assigned.
Education: A Bachelor's Degree in a related field or equivalent work experience.
Experience: 3 years experience within a regulatory affairs/ compliance enviornment. Familiarity with Medicare and Medicaid programs preferred. Previous State or Federal managed care compliance experience a plus.
Special Skills (e.g. 2nd language):
Strong attention to deadlines and details
Ability to exercise good judgment under pressure
Ability to manage a diverse and demanding workload
Ability to work well both independently and with others in a matrix environment.
Ability to effectively present information and respond to inquiries from employees, regulatory agencies, and others, as necessary.
Ability to read, analyze, and interpret State and Federal laws, rules and regulations
- Technical Skills/Requirements: Advanced in Microsoft Office such as Word, Excel, PowerPoint, Project, Outlook and Access.