Leads the State Regulatory Affairs department responsible for developing and executing the Medicaid Regulatory Affairs strategy focused on publicly funded healthcare programs. Provides guidance, oversight and support to Regulatory Affairs teams with respect to contract administration and account management.
Reports to: State President
Location: Lincoln, NE
Additional Responsibilities:Candidate Education:
- Identifies, compiles and aggregates regulatory and operational issues across markets to manage risk. Partners with markets on resolutions through expertise and lessons learned.
- Makes timely and effective decisions using data and takes a fact-based approach to problem-solving, while understanding the limits of data to make and support decisions.
- Establishes the Medicaid Regulatory Affairs strategy and oversees contract administration activities in markets.
- Manages and supports audits and implementations to ensure regulatory requirements are satisfied.
- In partnership with Corporate Compliance, develops procedures, toolkits and reports and monitors contractually required deliverables, including but not limited to, regulatory reports and performance metrics.
- Develops procedures and toolkits for Account Management Plans and monitors adherence with corporate processes.
- Directs and manages a team of associates responsible for supporting Medicaid Regulatory Affairs initiatives and teams.
- Supports development and implementation of Regulatory Affairs in new markets.
- Develops and manages department budget.
- Performs special projects as needed.
- Required A Bachelor's Degree in business administration or related field
- Preferred A Master's Degree in public policy, public health, political science, health administration or related field
- Required 10 years of experience in managed health care or health care consulting
- Required 7 years of experience in regulatory affairs, government relations, compliance or related disipline
- Required 5 years of management experience
- Advanced Demonstrated interpersonal/verbal communication skills
- Advanced Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
- Advanced Ability to drive multiple projects
- Advanced Ability to influence internal and external constituents
- Advanced Ability to lead/manage others
- Advanced Demonstrated written communication skills
- Advanced Ability to work in a matrixed environment
- Advanced Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
- Advanced Ability to proof large bodies of materials
- Advanced Demonstrated leadership skills
- Advanced Demonstrated project management skills
- Advanced Other In-depth knowledge of government programs and the managed care industry and experience leading and managing regulatory affairs programs through teamwork, collaboration and open communication
- Required Intermediate Microsoft Project Strong knowledge of MS Office including Project, Access, PowerPoint and Visio
- Required Intermediate Microsoft Access Knowledge of and/or ability to utilize COGNOS for budgetary decisions or review
- Required Intermediate Microsoft PowerPoint
- Required Intermediate Microsoft Visio
- Required Intermediate Other Knowledge of and/or ability to utilize COGNOS for budgetary decisions or review